Aberdeen Varicose Vein Questionnaire Research Articles

COMPARISON BETWEEN CONVENTIONAL HIGH LIGATION AND STRIPPING AND RADIOFREQUENCY ABLATION FOR GREAT SAPHENOUS VARICOSE VEINS

The prospective study was conducted from December 2022 to May 2023 to assess patient-based, radiological, and clinical outcomes after conventional surgery and radiofrequency ablation for great saphenous varicose veins. Patients were randomly divided to undergo conventional surgery or RFA. American Society of Anesthesiologists fitness grade, Venous Disability Score (VDS), Total Clinical Severity Score (TCSS), Michael's, and CEAP clinical classes were recorded. VEINES-QoL/Sym questionnaire and Aberdeen Varicose Vein Questionnaire were used to estimate baseline QoL. Patients were called for follow-up at the end of 1st and 5th week. The study was conducted on a total of 110 patients. Patients were randomly divided; 57 underwent RFA, and 53 underwent conventional surgery. Results showed that the difference between both groups regarding anesthesia induction, recovery, and discharge from surgery was insignificant. RFA had significantly longer total theater time compared to conventional surgery. Duplex imaging showed that RFA resulted in successful ablation except in two cases where veins had segmental brisk flow. These cases were retreated successfully. Conventional surgery only had the problem of incomplete stripping (6 cases). Post-operative pain, bruising, and the need for analgesia were significantly higher following conservative surgery. Patients in the RFA group returned to work and normal activities more quickly than the conventional surgery group. It is concluded that RFA had a longer intervention time but significantly better outcomes than conventional surgery.

Quantifiable remaining reflux 1 year after treatment of superficial venous incompetence is associated with impaired clinical outcome

ObjectiveRemaining symptoms after treatment of superficial venous incompetence is a common problem. Duplex ultrasound is often used during follow-up, but does not permit an overall quantification of venous function. We have developed a plethysmographic method using occlusion cuffs for separation of superficial and deep venous reflux. By assessing the superficial component it is possible to quantify a potential suboptimal hemodynamic treatment in patients with superficial venous incompetence. The aim was to examine whether patients with hemodynamically quantifiable remaining reflux after treatment experience impaired clinical outcomes. MethodsThis single-center prospective cohort study evaluated 156 limbs with great saphenous vein incompetence treated with radiofrequency ablation or high ligation and stripping. Duplex ultrasound and strain-gauge plethysmography (SGP) with and without selective superficial occlusion were performed before and one-year after treatment. Time taken (seconds) to reach 50% of the venous volume (T50) was evaluated. A difference in the T50of >5 seconds between postoperative strain-gauge plethysmography with and without superficial occlusion was defined as remaining reflux. The Venous Clinical Severity Score (VCSS) and Aberdeen Varicose Vein Questionnaire (AVVQ) were evaluated and compared between patients with and without remaining reflux. Multivariable logistic regression was used to evaluate risk factors for remaining plethysmographic reflux. ResultsIn all patients, median (25th, 75th percentile) T50 increased preoperatively from 7 seconds (3, 12 seconds) to 17 seconds (11, 28 seconds) (P < .001) 1 year after treatment. The VCSS and AVVQ were reduced (VCSS, 8.0 [6.0, 10.0] vs 3.0 [1.0, 5.0] [P < .001]; AVVQ, 21.8 [15.8, 32.1] vs 6.4 [2.2, 11.0] [P < .001]). Of the 156 limbs, 87 (56%) demonstrated remaining reflux 1 year after treatment. Patients with remaining plethysmographic reflux displayed higher median (25th, 75th percentile) VCSS (3.0 [2.0, 5.0] vs 2.0 [1.0, 4.0]; P = .012) and AVVQ (7.5 [2.7, 14.9] vs 4.7 [1.6, 9.2]; P = .025). Multivariate logistic regression showed that higher preoperative C in the Clinical Etiology Anatomy Pathophysiology classification (CEAP) (odds ratio [OR], 2.9 [95% confidence interval [CI], 1.34-6.46), age (OR, 1.03; 95% CI, 1.001-1.065), small saphenous vein incompetence (OR, 4.2; 95% CI, 1.30-13.73) and postoperative great saphenous vein reflux below the treated area (OR, 2.16; 95% CI, 1.02-4.56) were significant risk factors for remaining plethysmographic reflux. ConclusionsA majority of treated limbs showed quantifiable reflux 1 year after intervention and these patients displayed worse patient related outcomes assessed with the VCSS and AVVQ. Remaining plethysmographic reflux was associated with preoperative small saphenous vein incompetence and reflux below the treated area as well as advanced age and higher C in CEAP.

A comparison of patient-reported outcome measures following technical success and technical failure in the treatment of great saphenous vein incompetence using ClariVein: A subanalysis of a multicenter randomized controlled trial comparing 2% and 3% polidocanol.

This study aimed to compare patient-reported outcomes after technical success (TS) and technical failure (TF) in treating great saphenous vein incompetence (GSV) with ClariVein. A subanalysis of a previous trial was conducted on symptomatic GSV incompetence patients who received ClariVein treatment with 2% or 3% polidocanol (POL) and were followed for 6months. Blinding was implemented for observers and patients, and data from both POL groups were combined. TS was defined as at least 85% occlusion of the treated vein, while TF indicated failure to meet TS criteria. Secondary outcomes included Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ), and Short-Form 36 Health Survey Questionnaire (SF-36). Among the 364 patients included, the TS rate was 64.5%. Comparison of VCSS, AVVQ, and SF-36 scores between TS and TF groups did not yield significant differences. This study indicates no significant variation in VCSS, AVVQ, and SF-36 scores between patients experiencing TS and TF following ClariVein treatment for GSV insufficiency.

Endovenous Microwave Ablation Versus Radiofrequency Ablation for the Treatment of Lower Limb Varicose Veins

This study aimed to retrospectively compare the clinical outcomes of endovenous microwave versus radiofrequency ablation combined with foam sclerotherapy in patients with lower limb varicose veins. We identified patients with lower limb varicose veins treated with endovenous microwave ablation or radiofrequency ablation with foam sclerotherapy between January 2018 and June 2021 at our institution. Patients were followed-up for 12months. Clinical results, including the pre-post-Aberdeen Varicose Vein Questionnaire and post-Aberdeen Varicose Vein Questionnaire and Venous Clinical Severity Score, were compared. Complications were documented and treated accordingly. We included 287 cases (295 limbs total; endovenous microwave ablation+foam sclerosing agent: n=142, 146 limbs; radiofrequency ablation+foam sclerosing agent: n=145, 149 limbs). The operative time was shorter for endovenous microwave ablation than radiofrequency ablation (42.58±15.62min vs. 65.46±24.38min, P<0.05); however, other procedural parameters did not differ. Furthermore, hospitalization costs for endovenous microwave ablation were lower than those for radiofrequency ablation (21,063.74±850.47 yuan vs. 23,312.40±1,035.86 yuan, P<0.05). At the 12-month follow-up, the great saphenous vein closure rate was similar in both groups (endovenous microwave ablation, 97% [142/146] vs. radiofrequency ablation, 98% [146/149]; P>0.05). Additionally, the satisfaction or incidence rates of complications were not different among the groups. In both groups, the Aberdeen Varicose Vein Questionnaire and Venous Clinical Severity Score values were significantly lower 12months postsurgery than before surgery; however, the postoperative values did not differ. Endovenous microwave ablation effectively treated lower limb varicose veins, with similar short-term effects as radiofrequency ablation. Moreover, it had a shorter operative time and was less expensive than endovenous radiofrequency ablation.

One Year Follow-Up of Endovascular Microwave Ablation and Concomitant Foam Sclerotherapy in the Treatment of Primary Small Saphenous Vein Insufficiency

In the last decade, the microwave ablation (MWA) catheter specifically for treating lower extremity varicose veins has become popular. However, imited data is available on the efficacy, analysis, and evaluation of endovenous microwave ablation (EMWA) in treating SSV insufficiency. This study evaluated the feasibility, safety, and 1-year outcomes of endovenous microwave ablation and concomitant foam sclerotherapy of primary small saphenous vein (SSV) insufficiency. Our team carried out a single-center, retrospective analysis of 24 patients treated with endovenous microwave ablation and concomitant foam sclerotherapy for primary SSV insufficiency. All operations were performed using a microwave ablation catheter and polidocanol for the trunk and branches of the SSV, respectively. The SSV occlusion rate was assessed at the 6- and 12-month follow-up examinations using duplex ultrasound. Secondary outcomes included the Clinical, Etiological, Anatomical, Pathophysiological (CEAP) clinical class; Venous Clinical Severity Score (VCSS); Aberdeen Varicose Vein Questionnaire (AVVQ); periprocedural pain; and complications. 100% of the cases have been technically successful. At the 6-month follow-up, all treated SSVs were occluded. The 12-month assessment duplex doppler showed anatomical success in patients with 95.8% (95% confidence interval, 0.756-0.994). The CEAP clinical class, VCSS, and the AVVQ had decreased significantly at the 6-, and 12-month follow-up, respectively. Endovenous microwave ablation and concomitant foam sclerotherapy is a feasible and effective technique for treating SSV insufficiency.

O018 Determining the relationships between venous reflux patterns, clinical severity, and health-related quality of life

Abstract Introduction Various classification systems have been created to describe the anatomical distribution of venous reflux, including the VEIN-TERM and Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. It is still unclear whether different reflux patterns correlate with health-related quality of life (HRQoL) and clinical severity. Methods Some 507 chronic venous disease patients and 105 asymptomatic controls underwent duplex ultrasound assessment. Patients were stratified according to VEIN-TERM and the CEAP classification systems. The Aberdeen Varicose Vein Questionnaire (AVVQ) score was used to compare HRQoL and the Venous Clinical Severity Score (VCSS) was used to compare clinical severity between groups. Results Patients were significantly older than controls (p&amp;lt;0.00001). All VEIN-TERM reflux patterns had significantly greater VCSS than no reflux (p&amp;lt;0.001). Superficial axial and combined axial reflux were associated with significantly greater VCSS than superficial segmental reflux (p&amp;lt;0.001, p=0.042 respectively). All VEIN-TERM reflux types had significantly worse AVVQ scores than no reflux (p&amp;lt;0.03). However, there were no significant differences in AVVQ scores across all VEIN-TERM reflux patterns. Most CEAP reflux patterns had increased VCSS and worse AVVQ scores when compared to no reflux (all p&amp;lt;0.05), except for deep reflux, and deep and perforator reflux only. The deep, superficial and perforator reflux group had significantly higher VCSS (p=0.013) and AVVQ (p&amp;lt;0.001) versus the superficial reflux only group. Conclusion When compared to no reflux, both classification systems show associations of any reflux pattern with worse VCSS and AVVQ scores. Combined reflux patterns were associated with the greatest clinical severity and worst HRQoL scores.

Combined effect of yoga and naturopathy in uncomplicated varicose vein disease – a prospective randomized controlled trial

BackgroundThough the treatment of uncomplicated varicose vein (UVV) might prevent late complications such as skin change or ulceration, but, there are limited studies available to justify this concept. Yoga and Naturopathy being a proficient tool in managing non communicable diseases including many cardiovascular diseases; no attempt was made to study its potential effect in Varicose Vein diseases. ObjectiveThe present study aims to study the combination of Yoga and Naturopathy in uncomplicated varicose vein patients. Materials and methods50 UVV participants were prospectively recruited and randomly divided into two groups, Experimental and Active control groups. Both the groups practiced their respective interventions, and follow up was done after 1 and 3 months of active intervention. Finally study was completed with 46 participants (2 dropouts in each groups). The sample size was calculated based on the previous study, considering power as 0.8 and ‘α’ as 0.05, using ‘G’ power software. The variables such as Body weight, BMI, Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Heart rate (HR), high-sensitivity C-reactive protein (hs-CRP), homocysteine (HCy) were recorded before and after the intervention, but Aberdeen Varicose Vein Questionnaire (AVVQ) and Visual analogue heaviness scale (VAHS) were recorded on 60 and 120 days of the follow up in addition to active intervention period. ResultsThere was a significant decrease in hs-CRP (p < 0.05) in the experimental group as compared to the control group. Body weight, BMI, SBP, HR, hs-CRP, HCy (p < 0.001) and DBP (p < 0.05) significantly decreases following the Combined Yoga and Naturopathy (CYN) intervention for a month in the experimental group. Also, the AVVQ (p < 0.01) and VAHS (p < 0.05) decreases following active intervention and two consecutive follow up. No adverse event was noted during or after the trial. ConclusionThe combined effect of Yoga and Naturopathy reduced blood pressure and inflammatory markers suggestive of potential of recovery in inflammation in the endothelial tissue of the microvascular system in UVV patients. Trial Registry numberCTRI/2018/10/015895; Clinical Trials Registry- India; www.ctri.nic.in.

Translation and adaptation to Spanish of Aberdeen varicose veins questionnaire

The purpose of the study is to translate the Aberdeen Varicose Vein Questionnaire (AVVQ) into Spanish and evaluate the feasibility and reliability of the Spanish-translated AVVQ in patients with chronic venous disease. Reliability was assessed by test and retest of the Spanish translated AVVQ in a sample of 77 patients. The questionnaires were answered within a 2-week interval. There was a 100% test and retest response. The AVVQ showed 6.5% of missing responses. Cronbach's alpha was 0.71 indicating an adequate level of internal consistency. Spearman's rho showed a significant strong association between test and retest scores (rho = 0.84, p < 0.0001). The Spanish-translated AVVQ is a reliable tool in our daily clinical practice in order to measure the impact of venous disease in the quality of life.

Six Year Extension Study of Patients From a Randomised Clinical Trial Comparing Venefit, Radiofrequency Induced Thermal Therapy, and Endovenous Radiofrequency Ablation for Treatment of Incompetent Great Saphenous Veins

To compare long term outcomes after great saphenous vein (GSV) treatment with three radiofrequency (RF) thermal devices: Venefit (Closurefast), Radiofrequency Induced Thermal Therapy (RFITT), and Endovenous Radiofrequency (EVRF). A 72 month follow up of patients who were treated in the randomised 3RF study. A total of 172 participants from the 3RF study were invited to take part in a single visit, long term, follow up study. Failure of GSV closure was assessed with duplex ultrasound (DUS) and constituted the primary outcome. Patients completed questionnaires for secondary outcomes: Aberdeen Varicose Vein Questionnaire (AVVQ), Euroqol 5D (EQ-5D), and patient reported varicose veins measured by counting vein occupying boxes in AVVQ question 1. Twenty-two patients (12%) had already been re-treated. Of the remainder, 13 (7%) could not be contacted, 20 (11%) declined invitation, and one did not consent. Therefore, 116 (64%) and 95 (53%) participants completed questionnaires and DUS, respectively. Failure of GSV closure on 72 month DUS was 16%, 21%, and 37% for Venefit, RFITT, and EVRF, respectively (p= .14), whilst outcomes for all failures were 14%, 17%, and 44% (p < .001) (Venefit vs. EVRF: p < .001; RFITT vs. EVRF: p < .001; and Venefit vs. RFITT: p= .63). There were no between group differences in AVVQ or EQ-5D scores. Rates of patient reported presence of any varicose veins were high for all groups (97%, 92%, and 97% after Venefit, RFITT, and EVRF, respectively; p= .48). The EVRF treated participants reported more extensive recurrence than the Venefit and RFITT participants (p= .008). Long term technical outcomes after RF ablation for GSV varicose veins were significantly better after Venefit and RFITT compared with EVRF treatment. However, quality of life scores showed no differences after 72 months. Rates of patient reporting any varicose veins were high for all treatments. gov Identifier: NCT04720027.

Clinical outcomes following mechanochemical ablation of superficial venous incompetence compared with endothermal ablation: meta-analysis.

Mechanochemical ablation (MOCA) is an alternative method to endovenous thermal ablation (EVTA) for the treatment of superficial venous incompetence that does not require tumescent anaesthesia. The aim of this study was to compare the outcomes from RCTs of MOCA versus EVTA. A search was conducted in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). Meta-analysis inclusion was restricted to RCTs comparing MOCA against EVTA. Outcomes included anatomical occlusion rate, disease-specific quality of life using the Aberdeen Varicose Vein Questionnaire, procedural and postprocedural pain, and rates of venous thromboembolism. Four RCTs were included in the meta-analysis comprising 654 patients. The anatomical occlusion rate at 1 year was lower after MOCA than EVTA (risk ratio 0.85, 95 per cent c.i. 0.78 to 0.91; P < 0.001). No significant differences were detected in procedural pain (mean difference -3.25, -14.25 to 7.74; P = 0.560) or postprocedural pain (mean difference -0.63, -2.15 to 0.89; P = 0.420). There were no significant differences in Aberdeen Varicose Vein Questionnaire score at 1 year (mean difference 0.06, -0.50 to 0.62; P = 0.830) or in incidence of venous thromboembolism (risk ratio 0.72, 95 per cent c.i. 0.14 to 3.61; P = 0.690). The rate of successful anatomical occlusion after MOCA is significantly lower than that after EVTA, but there is no difference in procedural and postprocedural pain between the two interventions. Long-term data are required to assess the impact of the reduced vein occlusion rate on clinical outcomes such as quality of life and reintervention.

Early results of cyanoacrylate adhesive ablation versus laser ablation for the treatment of great saphenous vein insufficiency in the Chinese mainland population.

In this study, we present our early outcomes of cyanoacrylate ablation (CA) versus endovenous laser ablation (EVLA) for the treatment of great saphenous vein (GSV) insufficiency in the Chinese mainland population. We retrospectively analyzed 108 patients (53 patients in the CA group and 55 patients in the EVLA group) with GSV insufficiency who were treated with CA and EVLA between May 2020 and May 2021. The Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire were used to assess clinical symptoms and quality of life, respectively. Total closure rates and procedure-related adverse events were also recorded in both groups. There was no significant difference between patients treated with CA or EVLA in terms of demographic and clinical characteristics. The average procedure time was 17min in the CA group and 35min in the EVLA group (p < 0.001). The CA group had lower pain scores during the procedure and 3days afterward than the EVLA group (p < 0.001). At month 12, the CA group had a 90.4% closure rate, while the EVLA group had an 83.0% closure rate, with no significant difference between the two groups (p > 0.05). There was no significant difference in the Venous Clinical Severity Score or Aberdeen Varicose Vein Questionnaire score between the groups (p > 0.05). During follow-up, neither group experienced any significant adverse events, such as pulmonary embolism or deep venous thrombosis. The incidence of ecchymosis and paresthesia was significantly lower in the CA group than in the EVLA group (p < 0.05). Cyanoacrylate ablation has a high feasibility profile and is an effective approach to accomplish complete GSV target vein closure at early follow-up in the Chinese patients. Compared to EVLA, the improvement in quality-of-life outcomes is also sustained and similar, with less pain and fewer complications due to the absence of tumescence anesthesia and postprocedural compression stockings.

Evaluation of mid-term results in our patients treated with N-Butyl cyanoacrylate embolization in saphenous vein insufficiency

Aim: The aim of this study is to present our mid-term results obtained from patients with advanced saphenous vein insufficiency treated with N-butyl cyanoacrylate embolization (CAE). Material and Methods: In the present study, we included 1013 patients who were treated with CAE because of moderate and severe saphenous vein insufficiency in Eskişehir Osmangazi University Medical Faculty Hospital Cardiovascular Surgery Clinic between January 2015 and November 2019. The patients were rechecked at 1st, 6th, 12th, 24th and 36th months. Venous Clinical Severity Score (VCSS) and Aberdeen Varicose Vein Questionnaire (AVVQ) results recorded at preoperative and postoperativee period. Doppler ultrasonography (USG) was performed to all patients in all controls. The absence of re-canalized flow in Doppler USG was accepted as the success of the procedure. Results: The mean age of 1013 patients was 51.27±14.30 years (448 men (44.2%) and 565 women (55.8%)). The average procedure time was 12.4±2.1 minutes, the average amount of CA used in the procedure was 1.6 ml (min: 1 ml - max: 2ml). In outpatient controls, complication rates was low, thrombophlebitis occurred in 17 patients (1.7%) and ecchymosis occurred in 9 patients (0.9%). The occlusion rate was 97.6% according to the 1-year follow-up results and 93.3% according to the 3-year follow-up results. The decrease in VCSS and AVVQ scores was statistically significant when the preoperative and postoperative period results compared (p&lt;.05). Conclusion: In the present study, we think that CAE is a safely and effective treatment method for saphenous vein insufficiency. It has low complication, high occlusion rates and provides better comfort to the patients.

SA37 Cultural Adaptation and Sociometric Analysis of Aberdeen Varicose Vein Questionnaire

The purpose of our study was to translate and adapt the Aberdeen Varicose Vein Questionnaire (AVVQ) into Hungarian language, and to investigate the sociometric properties of the Hungarian AVVQ, as well as to assess the health-related quality of life of patients suffering from varicose vein disease.

Comparison of 5-year outcomes and quality of life between endovenous laser (980 nm) and microwave ablation combined with high ligation for varicose veins.

Our study aims to evaluateand compare the long-term results of endovenous laser (EVLA) and microwave ablation (EMA) combined with high ligation in treating varicose veins (VVs). A total of 122 patients (150 legs) underwent EMA combined with high ligation, and 127 patients (167 legs) underwent EVLA procedures (980 nm) combined with high ligation in this retrospective study. Outcomes included the Aberdeen Varicose Vein Questionnaire (AVVQ) score, the Venous Clinical Severity Score (VCSS), clinical recurrence of VVs and patient satisfaction duringthe 5-year follow-up.During the 5-year follow-up, patients who underwent the EVLA procedure showed a higher recurrence of VVs than those who underwent the EMA procedure (22.75% vs. 13.33%, P = 0.03, odds ratio (OR): 1.91, 95% confidence interval (CI): 1.06-3.45), especially at the primary site (6% vs. 14.37%, P = 0.01; OR: 2.63; 95% CI: 1.21-5.72). VV recurrence within 3 years was higher in patients who underwent EVLA than in those who underwent the EMA procedure (73.68% vs. 40%, P = 0.01; OR: 4.2; 95% CI: 1.37-12.86). Compared with those at baseline, the AVVQ score, VCSS and EQ-5D score improved significantly at 5 years for patients who underwent either procedure (P < 0.01); however, the VCSS and AVVQ score were higher for patients who underwent the EVLA procedure (P = 0.05). The patient reintervention rate was higher for EVLA than for EMA (14.79% vs. 7.33%, P = 0.033; OR: 2.19; 95% CI: 2.06-5.34). Our results confirmed that EMA and EVLA improve the QoL of patients and that EMA combined with high ligation demonstrates lower 5-year recurrence, especially at primary sites.

Compression versus no compression after endovenous radiofrequency ablation: A meta-analysis of randomized controlled trials.

The aim of this meta-analysis was to compare compression with no-compression, after radiofrequency endothermal ablation of a truncal varicose vein. Databases, such as PubMed, Embase, Cochran Library, and Web of Science, were independently searched by two researchers for relevant literature, preliminary screening was performed, and the full text was read to select studies that met the inclusion criteria. The quality of the included literature was evaluated using the Cochrane Risk of Bias tool, and meta-analysis was performed using Review Manager 5.4. A total of four randomized controlled trials were included and a total of 552 patients were involved. Among them, 273 patients were in the compression group and 279 in the no-compression group. Meta-analysis results showed that the pain using the 100mm Visual Analogue Scale was lower in the compression group than the pain in the no-compression group (MD = -4.22, 95% CI = -7.95 - -0.49, p = 0.03). No significant differences in terms of occlusion rate (RR = 0.99, 95% CI = 0.96-1.02, p = 0.55), Aberdeen Varicose Vein Questionnaire (MD = 0.46, 95% CI = -0.80-1.73, p = 0.47), and complications (OR = 1.33, 95% CI = 0.61-2.94, p = 0.47) were observed between groups. This meta-analysis suggests that compression therapy reduced post-operative pain compared to the no-compression group. However, no additional advantages were observed in terms of occlusion rates, quality of life scores and complications.

Relationship between clinical severity and hemodynamic impact of great saphenous vein incompetence using strain gauge plethysmography and duplex ultrasound.

To evaluate the relation of quantitative Duplex ultrasound (DUS) and strain gauge plethysmography (SGP) parameters with clinical severity and quality of life in patients with superficial venous incompetence. DUS volume flow and distal SGP refilling times (T50 and T90) were evaluated in 152 patients (164 Limbs) with superficial incompetence. Clinical severity and quality of life were evaluated with C of the CEAP classification, venous clinical severity score (VCSS), Aberdeen varicose vein questionnaire (AVVQ), and EuroQol 5D-3L. Higher DUS volume flow was associated with higher C in CEAP scores. Volume flow was also related to T50 and T90. Shorter T50 and T90 were associated with higher C in CEAP and VCSS. T50 was also associated with EQ-5DVAS. Reflux extension to the foot wase associated with shorter T50 and T90 and higher DUS volume flow. DUS volume flow and SGP refilling times are related with clinical severity and provide quantitative information regarding venous function in patients with superficial incompetence.

Efficacy and safety of endovenous microwave ablation versus laser ablation for great saphenous vein varicosis: study protocol for a multicentre, randomised controlled non-inferiority trial

IntroductionEndovenous microwave ablation (EMA) is a relatively novel thermal ablation treatment for great saphenous vein (GSV) varicosis, and its efficacy and safety are rarely reported. This study aims to explore...

Clinical outcomes of different endovenous procedures among patients with varicose veins and iliac vein compression: A retrospective cohort study

ObjectiveThis study aimed to investigate the short-term outcomes of three endovenous procedures in patients with varicose veins (VVs) and severe iliac vein compression syndrome (IVCS). MethodsA total of 158 consecutive patients were included in this multicenter retrospective study from May 2017 to December 2019; 54 patients underwent endovenous laser ablation (EVLA) alone, 47 patients underwent EVLA and balloon angioplasty (BA), and 57 patients underwent EVLA and stenting angioplasty (SA). Clinical outcomes and complications were assessed at one and twelve months post-surgery. The Quality of life (QoL) was assessed by the venous clinical severity score (VCSS) and Aberdeen Varicose Vein Questionnaire (AVVQ). ResultsPatients who underwent the SA procedure were older (P < 0.05). Incidence of laser ablation complications was similar among the three procedures; closure rates of the great saphenous vein were 96.8%, 98.0%, and 98.4%, respectively, at 12 months. Reflux times in the SA procedure were lower than those in the EVLA and BA procedures at 12 months, while ulcer healing time was faster with the SA procedure (P < 0.05) than with the other procedures. The VCSS and AVVQ values were significantly improved post-procedure (P < 0.05), with lower AVVQ scores in the SA procedure than in the EVLA and BA procedures at 12 months post-surgery. The EVLA and BA procedures (stenosis >70%) caused a significantly higher symptom recurrence than the SA procedure, with an odds ratios of 14.04 (95% confidence interval (CI), 1.99–99.18) and 10.50 (95% CI, 1.26–87.15), respectively. ConclusionsOur results demonstrate that EVLA and SA procedures relieve symptoms, improve the QoL, and decrease symptom recurrence in patients with VVs and severe IVCS (stenosis >70%).

Is catheter-based foam sclerotherapy more effective than direct foam sclerotherapy when combined with high ligation for the treatment of primary great saphenous vein incompetence?

To retrospectively analyze the short-term outcomes of catheter-based versus direct foam sclerotherapy when combined with high ligation (HL) for the treatment of great saphenous vein (GSV) incompetence. From July 2018 to October 2019, a total of 82 lower limbs of 70 patients with GSV incompetence received HL combined with catheter-based foam sclerotherapy (CFS group) or direct foam sclerotherapy (DFS group) for GSV proximal trunk. Among them, 40 limbs of 36 patients were treated with CFS, and 42 limbs of 34 patients were treated with DFS. The occlusion of GSV proximal trunk was evaluated with venous duplex ultrasound examinations; Venous Clinical Severity Scores (VCSS) was used to assess clinical improvement; Aberdeen Varicose Veins Questionnaire (AVVQ) was used to assess quality-of-life scores; and Complications was used for the safety evaluation. At day 7 post-operatively, complete occlusion of proximal trunk of the GSV was achieved in 92.5% legs of the CFS group and 71.4% of the DFS group (p = 0.014). Additionally, anterograde flow was found in 7.5% legs of the CFS group and 26.2% of the DFS group (p = 0.025). No significant differences in the occurrence of complications were observed between the two groups. The median follow-up was 285.5days in the DFS group and 318days in the CFS group (p = 0.140). VCSS and AVVQ reduction were significant in both CFS group and DFS group (5.3 ± 2.5, 5.5 ± 2.4, p < 0.001 for VCSS; 15.9 ± 8.0, 16.3 ± 8.6, p < 0.001 for AVVQ), but no significant difference were observed between two groups (p = 0.655 for VCSS, p = 0.934 for AVVQ). Although the occlusion of great saphenous vein proximal trunk were different, two modalities result in similar clinical and quality-of-life improvements. DFS is a feasible alternative to CFS when combined with HL.

TRANSCULTURAL ADAPTATION AND VALIDATION OF THE UKRAINIAN VERSION OF THE SPECIALIZED PHLEBOLOGICAL QUESTIONNAIRE FOR QUALITY OF LIFE ASSESSMENT

Today, quality of life assessment is an informative, reliable and economical method of studying health, both at the individual and group levels, and is an important integral indicator of the severity and dynamics of the pathological process in different nosologies. The most convenient way to measure the quality of life is to use questionnaires, which are divided into general, used for all diseases, and specialized, used for a particular nosological unit. Proper construction of quality of life questionnaires is extremely important for obtaining objective information, and in the case of using foreign language versions, it is necessary not only to make a correct translation, but also to follow the procedure of transcultural adaptation and validation. A number of general quality of life questionnaires (SF-36, Euro-Quality of Life 5D-5L) have Ukrainian versions and have been adapted and validated in accordance with international requirements. As for specialized phlebological questionnaires for quality of life assessment, after analyzing the available information resources, we did not find any description of the process of transcultural adaptation and validation of questionnaires for patients with varicose veins of the lower extremities in Ukrainian language, which became the basis of our work, during which, in accordance with the recommendations of the WHO and the Professional Society for Health Economics and Outcomes Research, the process of transcultural adaptation of the specialized phlebological questionnaire for quality of life assessment, Aberdeen Varicose Vein Questionnaire, was conducted. The validity of the adapted Ukrainian version of the questionnaire was determined using various methods: by analyzing the internal stability (Cronbach's coefficient), which according to the study is 0.76, which is comparable to the original version of the questionnaire and shows the internal consistency of the questionnaire. The next tool used to determine the validity of questionnaire questions is the "test-retest" method: conducting two tests with an interval of 14 days. According to the results of this method, a strong direct relationship with the overall Spearman coefficient = 0.965 (p &lt;0.01) prevailed, which indicates a reliable repeatability of the test. The result of the Lawshe validation assessment aimed at the involvement of specialized experts and confirmed the importance of all 13 questions of the questionnaire for assessing the quality of life in patients with varicose veins of the lower extremities. Based on the study, the following conclusions were made: the Ukrainian language version of the AVVQ phlebological questionnaire, performed in accordance with international standards of language and cultural adaptation is an effective tool for assessing quality of life in patients with varicose veins of the lower extremities. The total quality of life assessment significantly complements the characteristics of the pathological process in patients with varicose veins of the lower extremities, its dynamics under the influence of various treatment measures, provides valuable information about the patient's response to the disease and treatment. The Ukrainian-language version of AVVQ can be used as a guide to record changes in the quality of life of people with varicose veins of the lower extremities and used in the future as an independent, no less important indicator than the usual clinical and sonographic criteria.