Venous Ulcer: Could Endovenous Radiofrequency Ablation Improve Ulcer Healing? Preliminary Results of a Randomized Controlled Trial

Puggina, Juliana; Campos, Walter; Porta, Rina Maria Pereira; Santos, Jorgete Barreto dos; Silva, Erasmo Simão da; Luccia, Nélson De; Puech-Leão, Pedro; Aun, Ricardo; Sincos, Anna Paula Weinhardt Baptista; Collares, F.; Sincos, Igor Rafael

doi:10.1016/j.jvsv.2017.12.029

Cited by 2 publications

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“…They found out that healing processed with continuing obliteration of the great saphenous vein and loss of flow. 21,22 Puggina et al 20 conducted a randomized trial in Brazil on patients with venous ulcers without deep venous thrombosis receiving either radiofrequency ablation or two-layer compression bandage system. The results of their study showed venous ulcer healing rates had been higher in patients whom received endovenous radiofrequency ablation and two-layer compression bandages when compared with patients whom only received compression bandages alone.…”

Section: Discussionmentioning

confidence: 99%

“…18 Hence, it should also be noted that multicomponent compression bandage systems are still the simplest and the gold standard options to treat venous ulcers. 20 Although in the study by Bello et al 18 in 2002, isolated superficial venous surgery in patients with venous ulceration had been promising in ulcer healing in majority of the patients without the need for perforating surgery, compression therapy, or skin grafting; recent evidence indicates perforator vein surgery reduced the recurrences by van Gent et al 5 in 2010.…”

Section: Discussionmentioning

confidence: 99%

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Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Erdinç

2022

Phlebology

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Introduction In this study, we aimed to investigate the efficiency of endovenous laser and glue ablation techniques and compared the results with conventional surgical stripping. Patients and Methods Between January 2005 and January 2020, among 3133 consecutive patients with superficial venous reflux disease receiving treatment at our institution, there were 112 consecutive patients with active venous ulcers. Patients were divided into 3 groups as receiving conventional open surgical treatment (Group 1, n: 70), endovenous glue ablation (Group 2, n: 20), and endovenous laser ablation (Group 3, n: 22). Comorbidity factors, duration and size of the ulcers, deep, perforating, and small saphenous vein disease detected with detailed Doppler ultrasonography, and duration for healing and recurrence were investigated. Results The age, gender, comorbidities, smoking, history of previous treatment, diameter of the small saphenous vein, number of refluxing perforating veins, size of the ulcer, and ulcer recurrence ratio were not significantly different between groups. There were 7 patients with bilateral disease and in total 119 legs were intervened. Mean durations for complete ulcer healing were significantly lower in Group 1 (53.28 ± 22.1 days) than Group 2 (73.7 ± 39.6 days); however, it did not differ significantly between Group 1 and Group 3 (62.59 ± 19.65 days), and Group 2 and Group 3 ( p: 0.26). Ulcers recurred in 23 patients (33%) in stripping group at a mean follow up of 14.42 ± 4.6 months, in 7 patients (35%) in glue ablation group at a mean follow up of 11.97 ± 2.94 months, and in 5 patients (23%) in laser ablation group at a mean follow up of 12.66 ± 3.48 months ( p > 0.05 for all). Increased body mass index, co-existence of chronic venous insufficiency, active cigarette smoking, non-compliance with physician advises and exercise and compression stockings, and depth of the ulcers were correlated with recurrence. Conclusion The rationelle beyond treatment of the venous ulcers and prevention of recurrence relies on relief of the venous hypertension by interventional methods and/or compression therapy. None of the methods is superior over the others. Healing in short term without further recurrence may be achieved with successful intervention as well as good patient compliance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Erdinç

2022

Phlebology

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“…1 The gold standard for venous ulcer treatment is compression therapy, which achieves healing in high proportion of cases within 6 months; however, the problem is the high recurrence of the condition in the same or nearby sites together with the high costs of multiple cycles of lifelong treatment. 2,3 Therefore, it is of utmost importance to discover and then treat the exact pathological cause.…”

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confidence: 99%

Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization

Kamhawy

El‐Barbary

Elhenidy

et al. 2019

The International Journal of Lower Extremity Wounds

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High recurrence and high costs of treatment are the main problems with venous ulcer management. Therefore, it is of utmost importance to target the exact pathological cause. The role of cutaneous microvalves reflux in the pathogenesis of these ulcers has been confirmed. In this study, 20 chronic venous leg ulcers were prospectively subjected to foam sclerotherapy injection into periulcer veins using direct visualization by AccuVein AV400. Patients having infected ulcers, acute deep vein thrombosis, hypercoagulability, Ankle-Brachial Index <0.9, pregnancy, and/or allergy to the sclerosant were excluded. Endpoints included rates of ulcer size reduction, complete healing, ulcer recurrence, and procedure-related complications. Aethoxysklerol 1% was used in all cases to produce foam employing the double-syringe system. The mean reduction in ulcer surface area, postinjection, was 75% after 8 weeks and 91% after 12 weeks. Nineteen ulcers (95%) healed in a median time of 8 weeks, range 3 to 17 weeks. At 1 year of follow-up, 18 patients (90%) were still ulcer-free, while 1 patient’s ulcer (5%) recurred 19 weeks postinjection. No major complications were encountered. Periulcer foam sclerotherapy injection, guided by vein visualization technology, should be one of the main lines of treatment of venous leg ulcers. It offers good results with regard to rapid ulcer healing and low recurrence rate without major risk. Randomized controlled trials are needed to establish these conclusions.

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Venous Ulcer: Could Endovenous Radiofrequency Ablation Improve Ulcer Healing? Preliminary Results of a Randomized Controlled Trial

Cited by 2 publications

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Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Efficiency of endovenous laser and glue ablation methods in comparison with conventional surgery for the treatment of venous ulcers

Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization

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