Ablation Of Saphenous Vein Research Articles

Abstract No. 661 - Arterio-venous fistula: a rare complication of saphenous vein ablation

Abstract No. 661 - Arterio-venous fistula: a rare complication of saphenous vein ablation

Value of delayed duplex ultrasound assessment after endothermal ablation of the great saphenous vein

Endothermal ablation (ETA) of the great saphenous vein (GSV) is associated with a small but definite risk of endothermal heat-induced thrombosis (EHIT) extending into the common femoral vein. Follow-up duplex ultrasound imaging to detect EHIT after ETA is considered standard of care, although the exact timing of duplex ultrasound imaging to detect EHIT after ETA remains unclear. We hypothesized that an additional duplex ultrasound assessment 1week after ETA would not identify a significant number of patients with EHIT and would significantly increase health care costs. This was a retrospective review of consecutive ETA GSV procedures from 2007 to 2014. All patients were evaluated with duplex ultrasound imaging on postprocedure day 1, and 79% of patients underwent a second ultrasound assessment 1week postprocedure. EHIT was considered present when proximal GSV closure progressed to level ≥4, based on a six-tier classification system. From January 1, 2007, until December 31, 2014, 842 patients underwent GSV ETA. Patients with EHIT were more likely to have had a prior deep venous thrombosis (DVT; P= .002) and a larger GSV (P= .006). Forty-three procedures (5.1%) were classified as having EHIT requiring anticoagulation, based on a level ≥4 proximal closure level. Of the 43patients with EHIT, 20 (47%) were found on the initial ultrasound assessment performed 24hours postprocedure, but 19 patients (44%) with EHIT would not have been identified with a single postoperative ultrasound scan performed 24hours after intervention. These 19 patients had a level ≤3 closure level at the duplex ultrasound scan performed 24hours postprocedure and progressed to EHIT on the delayed duplex ultrasound scan. Lastly, thrombotic complications in four patients (9%), representing three late DVT and one DVT/pulmonary embolism presenting to another hospital, would not have been identified regardless of the postoperative surveillance strategy. Maximum GSV diameter was the only significant predictor of progression to EHIT on multivariate analysis (P= .007). Based on 2014 United States dollars, the two-ultrasound surveillance paradigm is associated with health care charges of $31,109 per identified delayed venous thromboembolism event. Delayed duplex ultrasound assessment after ETA of the GSV comes with associated health care costs but does yield a significant number of patients with progression to EHIT. Better understanding of the timing, risk factors, and significance of EHIT is needed to cost-effectively care for patients after ETA for varicose veins.

Venous hemodynamic improvement after endovenous radiofrequency ablation of saphenous varicose veins.

Endovenous radiofrequency ablation (RFA) has been a viable treatment option for patients with saphenous varicose veins. The purpose of our study was to assess venous hemodynamic change before and after RFA by using air plethysmography (APG). We prospectively analyzed the data of consecutive 91 patients with 124 limbs who underwent RFA for primary varicose veins. Overall venous hemodynamics of the limb was assessed using APG. The Venous Filling Index (VFI) was determined as a measure of reflux (normal range, <2 mL). Duplex scanning were performed to evaluate saphenous vein occlusion, deep venous thrombus and endovenous heat-induced thrombosis (EHIT). The VFI were significantly reduced from 4.1±3.1 preoperatively to 1.4±1.0, 1.3±0.8 and 1.4±1.2 at 1 week, 1 month and 4 month postoperatively, respectively. The percentage of the VFI >2 mL/s was 77% preoperatively, while it significantly decreased to 17%, 16%, and 18% at 1 week, 1 month, and 4 month postoperatively, respectively. Duplex scanning showed 100% of saphenous vein occlusion and no significant EHIT II-IV. Correction or significant improvement of venous reflux was achieved by RFA. Together with duplex scanning findings, RFA is a safe and hemodynamically effective treatment for varicose veins.

Real time echo-guided endolaser for thermal ablation without perivenous tumescence

Abstract Background There is no consensus in the medical literature on the ideal procedure for endovenous laser application. Objective To assess the safety and efficacy of real time echo-guided endovenous laser for thermal ablation of great saphenous vein (GSV) incompetence, without perivenous tumescence. Methods Thirty-four limbs of patients with CEAP clinical scores of 2 to 6 and bilateral incompetence of the saphenofemoral junction (SFJ) and GSV, confirmed by Echo-Doppler, underwent endovenous laser therapy and were followed for 1 year. Laser ablation was performed using a 600 µ bare optical fiber introduced endovenously close to the malleolus along the full extent of the GSV in an anterograde direction, using a standardized echo-Doppler-guided AND? 15 watt continuous mode 980 nm diode laser with real-time monitoring of thermal ablation of the whole target vein. Adverse effects and complications were recorded. Results Hyperesthesia, cellulitis, and fibrous cord, all transitory, developed in 2.9% of the 34 limbs treated; 8.8% developed hypoesthesia in the perimalleolar region, which was transitory and had no clinical consequences; there were no cases of deep venous thrombosis. Immediate occlusion was achieved in 100% of the 34 saphenous veins that underwent photocoagulation, although one exhibited recanalization without reflux at 1-month follow-up. After 6 months and 1 year, occlusion was 100% according to echo-Doppler findings. Conclusions Real-time echo-guided 980 nm endovenous laser ablation without perivenous tumescence provided controlled thermal ablation with safe, effective, immediate and medium-term GSV occlusion and can therefore be recommended as a method for the treatment of chronic venous disease.

Quality of life after great saphenous vein ablation in Thai patients with great saphenous vein reflux

To determine the quality of life (QoL) in Thais after intervention for great saphenous vein (GSV) reflux. Patients with Clinical Etiologic Anatomic Pathophysiologic classes 2 and 3 were enrolled in this study. QoL was measured using the EuroQol descriptive system (EQ-5D) questionnaire, and patients chose to receive either endovenous treatment or surgery after consulting with their surgeons. The QoL before the intervention, at 1 week, and at 1 month after the intervention were evaluated. Patients who reported "no problem" in each domain of the EQ-5D questionnaire before and 1 month after the intervention were compared. Utility gain was estimated from the questionnaire and compared between clinical classes. The proportion of worsening QoL at 1 week after the intervention was compared between patients receiving endovenous procedures and surgery. A total of 83 patients-56 received endovenous procedures [23 received ultrasound-guided foam sclerotherapy (UGFS) and 33 received radiofrequency ablation (RFA)] and 27 received surgery-were enrolled. QoLs were significantly better in all domains after the intervention: pain/discomfort (58%), mobility (42%), anxiety/depression (38%), usual activities (19%), and self-care (9%). Utility gain was 0.255 (95% confidence interval: 0.197-0.313) and higher in class 3. At 1 week after the intervention, surgery had significantly higher patients with worse mobility scores. Among endovenous procedures, UGFS had higher patients with worse pain/discomfort scores than RFA at 1 week after the intervention (16% vs. 0%, p=0.025). GSV ablation for GSV reflux in Thai patients with CEAP C2 and C3 categories significantly improves both physical and mental QoL; patients who received endovenous procedures were found to have better early physical QoL.

Saphenous sparing laser modern options (comment to Gianesini et al., Veins and Lymphatics 2013;2:e21 and Veins and Lymphatics 2015;4:5246)

Not required

Cost-effectiveness of endovenous laser ablation of the great saphenous vein in patients with uncomplicated primary varicosis.

BackgroundAlthough widely applied, the cost-effectiveness of endovenous laser ablation (EVLT) for varicose veins has not been established.MethodsCost-effectiveness analysis was performed on the evaluation of EVLT for the treatment of uncomplicated varicose veins by using published data from randomizd clinical trials regarding the costs and the quality of life. Incremental cost per quality-adjusted life year (QALY) gained at 6 months following treatment was calculated. Sensitivity analysis was carried out to investigate the uncertainty associated with the results of our analysis.ResultsOver the time horizon of 1–6 months, it was found that the incremental cost of EVLT compared with conventional surgery was €466.66 and the incremental effect was −0.007 QALY at 1 month, −0.0075 QALY at 3 months and 0.0 QALY at 6 months. This shows that the strategy “EVLT” was dominated by the strategy “HL/S” at any time point for the base cases analyses. The results of various alternative economic evaluations indicated that EVLT may be a potentially cost effective (i.e. incremental cost effectiveness ratio of between €12158.67 and €514721.67 per QALY, respectively) treatment option compared to conventional surgical treatment for varicose veins with a certainty between 54.9 and 98.8 %.ConclusionFor patients with uncomplicated varicose veins and evidence of saphenofemoral reflux, surgical treatment for varicose veins offers a robust health benefit for relatively less costs compared to EVLT.

Radiofrequency ablation or stripping of large-diameter incompetent great saphenous varicose veins with C2 or C3 disease.

The objectives of this study were to compare the results of radiofrequency ablation (RFA) and stripping for large-diameter varicose target veins for the period of 1year, based on a composite end point; to analyze the pain severity on a digital rating scale for 7days after RFA and stripping; and to detect the factors affecting the level of postoperative pain using the cluster analysis. This was a multicenter retrospective cohort study. Two groups, stripping ≥14mm and RFA ≥14mm, of 129 varicose vein disease patients underwent surgical treatment in three specialized clinics. We eliminated symptomatic pathologic reflux with RFA in 64 patients and with stripping in 65 patients. In the postoperative phase, we evaluated the pain level, subcutaneous hemorrhage, and paresthesia. A composite end point with four components was used to analyze the results. These were three clinical adverse effects of the intervention (pain, hemorrhage, and paresthesia) and the technical outcome 1year after the surgical intervention. The frequency of favorable outcomes was 20 (30.8%) in the stripping ≥14mm group and 61 (95.3%) in the RFA ≥14mm group (P< .0001). The odds ratio for a favorable outcome between the RFA and the stripping groups was 45.8 (95% confidence interval, 44.5-47.0). The pain clusters that were moderate were created by patients after stripping. These clusters show a link between the pain level on the one hand and an increased body mass index and large vein diameter on the other hand. For large-diameter veins, RFA is superior to stripping in terms of favorable outcomes according to the composite end point chosen. Significant pain after stripping was linked to a large vein diameter and excess weight or adiposis.

Are side effects always undesirable?

SummaryIntroduction: The endovenous thermal ablation of the great saphenous vein due to varicosis changes the blood circulation in the groin. This could affect the venous drainage of the penis, especially the drainage of the corpus spongiosum over the external pudendal vein. There are a few cases in our clinic until now which had an enhanced swelling of the glans penis beside an erection.Objective: Is the enhancement of penile swelling caused by the targeted thermal ablation of the GSV without affecting the saphenofemoral tributaries in the groin?Material and Methods: To verify this enhanced swelling of the glans penis and change in the erectile function we want to ask 56 patients with a modified IIEF questionnaire.The IIEF is a validated questionnaire with a additional question for the swelling of the glans. We check the reliability of the additional question with 16 healthy males.Possible results: Hypothesis 1 (H+): There is an improvement of the erectile function. Hypothesis 2 (H-): There is a decrease of the erectile function. Hypothesis 3 (H0): There is no change of the erectile function. Schedule: 1.Preliminary assessment: Sept. 2014: ethical approval, Reliability of the additional question. 2. Main assessment: Oct. 2014 to May 2016. 3. Analysis of the data: May 2016 to Aug. 2016 4. Report of data: August 2016.

The fate of calf perforator veins after saphenous vein laser ablation.

We aimed to assess hemodynamic changes in calf perforator veins (PVs) after endovenous laser ablation (EVLA) of saphenous veins. The series comprised 60 limbs of 41 patients (27 female, 14 male; median age, 43 years [range, 22-78 years]) who underwent EVLA for varicose veins. All patients were prospectively evaluated by means of color Doppler ultrasonography before and after the procedure. EVLA did not change the rate of incompetent PVs (preoperatively, 154/483 [32%] vs. postoperatively, 167/501 [33%]; P = 0.173), but significantly increased the total number of all PVs (n=483 vs. n=501, P = 0.036). Following EVLA, 28% of the limbs had thrombosis of PVs, 34% had new US-detectable PVs, 42% showed new competency, and 52% showed new incompetency. New competent PVs were found more commonly in the medial leg (ablation site) than the lateral leg (nonablation site) (28.3% vs. 11.7%, P = 0.016), while new incompetent PVs were found more commonly in nonablation site than ablation site (31.7% vs. 18.3%, P = 0.086). Additionally, new competent PVs in the posterior leg were found more often in patients who had small saphenous vein ablation than patients who did not (30% vs. 0%, P = 0.002). EVLA induces numerous changes in calf PVs. These changes seem to result from flow offloading in ablation site and onloading in nonablation site in the early postablation period.

Study Protocol: Endovenous Ablation of Incompetent Saphenous Veins and Best Medical Therapy Versus Best Medical Therapy in Patients with Venous Leg Ulceration, a Multi-center Randomized Controlled Trial

Results: Initial audit showed that 82% of our theatre sessions did not start in time with a mean delay of 51.9 ( 53.1) minutes. In addition, 47% of the lists overran the finishing time with mean delay of 34.5 ( 47.9) minutes. Implementation of “Fistula first” significantly improved the number of late starting sessions to 56% with a mean delay of 22.6 ( 26.7) minutes (p 1⁄4 0.001). It also reduced overrunning lists to 35% with a mean delay in finishing time of 28.2 ( 48.9) minutes (p>0.05). Looking at dialysis access fistula, intervention reduced late starting sessions from 87.5% to 60% with mean delay reduction from 52.7 ( 41.8) to 20.13 ( 26.2) minutes (p 1⁄4 0.028). Conclusion: Fistula first proved its efficiency in reducing the delay is session starting and this experience could be adopted by other similar institutions.

Treatment of endovenous heat-induced thrombosis (EHIT) with rivaroxaban (Xarelto®)

SummaryIntroduction: Endovenous heat-induced thrombosis (EHIT) is a known complication after endovenous ablation of the superficial varicose veins (incidence rate 0–6 % (varies by definition and diagnostic algorithm). However, only expert suggestions for indication, duration and dosing of treatment drugs exist. The most common recommendation is low-molecular weight heparin in half-therapeutic dosage for EHIT class 2 and therapeutic dosage for patients with EHIT class 3 or 4. Rivaroxaban is an attractive option in the treatment of venous thromboembolic diseases due to the simplification of treatment.Case report: After successful ablation of the great saphenous vein (GSV) in a patient with complete insufficiency (Hach III) combined with sclerotherapy of superificial varicose veins of the calf the patient got a prophylactic anticoagulation with low-molecular weight heparin (LMWH) and compressions stockings grade II. Nevertheless we saw in the control-compression ultrasound after 7 days an asymptomatic EHIT class 1. Due the progression to EHIT class 3 after another seven days under watchful waiting we treated the patient with Rivaroxaban for 14 days. After the treatment we saw a complete resolution of the clot. Anticoagulant treatment and compression stockings (for three weeks after EVLT) were discontinued.

Recurrence of varicose veins after endovenous ablation of the great saphenous vein in randomized trials

Recurrence of varicose veins after surgery (REVAS) for saphenous incompetence has been well described after ligation and stripping (L&S) but not after the now most frequently performed method of saphenous ablation, endovenous ablation (EVA). The purpose of this study was to define the overall incidence of REVAS as well as both the sites of reflux and the causes of REVAS through a systematic review and meta-analysis of randomized controlled trials (RCTs) for EVA. These studies have the advantage of prospectively collected data and a uniform duplex follow-up. We searched databases (January 1, 2000 through July 1, 2014) for published RCTs evaluating EVA treatment of great saphenous vein (GSV) incompetence that employed endovenous laser ablation or radiofrequency ablation. RCTs were eliminated that (1) did not have follow-up of at least 2years, (2) did not obtain postoperative duplex scans, (3) did not clearly report the incidence of recurrent varicosities after GSV ablation, and (4) treated the small saphenous or anterior accessory saphenous veins. Of the 68 studies screened, 20 RCTs that employed EVA of the GSV were identified. Eight had a follow-up of at least 2years, but one was eliminated because of lack of information on both the site and cause of REVAS. The resultant seven RCTs provided eight comparisons (one study compared both types of EVA to a comparator arm): three used radiofrequency ablation, and five employed endovenous laser ablation. Overall recurrent varicose veins developed in 125 limbs after EVA (22%), with no difference in the incidence vs the L&S group (22%) based on the number of limbs available at the time of thedevelopment of recurrence for both groups, but this incidence is dependent on the length of follow-up after the initial treatment. The two studies with serial follow-up showed an approximate doubling of REVAS over time for both EVA andL&S. By contrast, the cause of REVAS was different between the two methods. Neovascularization occurred in only two limbs (2%) after EVA vs 18 (18%) in the L&S group. Recanalization was the most common cause of REVAS for EVA (32%; 40 of 125 limbs), followed by the development of anterior accessory saphenous vein incompetence (19%; 23 of 125 limbs). In contrast to other reports, incompetent calf perforating veins were an infrequent cause of REVAS (7%; eight of 125). There is no difference in the incidence of REVAS for EVA vs L&S, but the causes of REVAS are different with L&S, which has important implications for treatment.

Debate: should persistent incompetent truncal veins be treated immediately? The case in support of the statement.

Debate continues as to the best method of treating patients with varicose veins and which will lead to durable clinical outcomes. Many modern techniques of treating varicose veins rely on ablation of the saphenous vein alone or in combination with phlebectomy or sclerotherapy of varices. However, it has been suggested that methods which leave the saphenous trunk untreated may result in similar outcomes. A search of medical databases was made for literature which compared the outcomes of saphenous vein stripping, sclerotherapy and modern methods of vein ablation. Surgical methods which have been used range from simple phlebectomy, ligation of the saphenous trunk to stripping of the saphenous vein. Systematic comparison of striping of the saphenous vein in addition to ligation of the sapheno-femoral junction appears to improve the outcome of varicose veins surgery compared to saphenous ligation alone. The 21st century endovenous treatments for varicose veins all rely on ablating the saphenous trunk. Duplex ultrasound studies show some variation in the efficacy of saphenous ablation with these methods. However, a randomised clinical trial shows similar patient reported outcomes with all endovenous techniques and surgical stripping of the saphenous vein. A clinical series shows that after endovenous thermal ablation recurrent varices arise in residual sections of saphenous trunk, accessory veins and residual tributaries. Studies based on clinical criteria require follow-up of about six years to yield reliable data. Before this time varices may be forming but cannot be detected clinically and over-optimistic results of treatment are reported. Data from surgical and endovenous treatment studies suggest that the more extensive and effective the ablation of saphenous trunks, accessory veins and tributaries, the better the long-term outcome that is achieved.

Management of perforator vein aneurysms in the lower extremities.

Perforator vein aneurysms (PVAs) of the lower extremity have not been defined or reported. This study reports the clinical presentation of patients, the PVA characteristics, and the clinical outcome of their management. Patients with signs and symptoms of chronic venous disease who had a PVA were included. Diagnosis of a PVA was made with duplex ultrasound. Normal perforator veins have a diameter of<3mm. A PVA was defined as a diameter dilation of >9mm, and it was always found below the deep fascia. The topography and morphology of the aneurysms were described in detail. All PVAs were treated with subfascial ligation with or without aneurysm excision. All patients were followed up for a minimum of 3months with clinical examination and duplex ultrasound, and complications were noted. There were 21 aneurysms identified in 19 patients. Fourteen (73.7%) patients were female. The mean age at diagnosis was 49years with a standard deviation of 9. Aneurysm size ranged from 9.8 to 22.2mm, with a mean diameter of 15.7mm and a standard deviation of 3.8. Seventeen aneurysms were fusiform, one was saccular, and one was multilobar. The perforators of the great saphenous vein distribution were most frequently involved, whereas only one involved deep vein disease. Few patients had symptoms, such as pressure and pain directly over the affected perforator. There was no association between the location and size of the PVA and the severity of chronic venous disease. Fourteen patients were treated surgically; fivepatients preferred conservative treatment with elastic compression stockings. Fourteen patients (73.7%) had ligation with (n= 9) or without (n= 5) excision of the aneurysm. All underwent concomitant phlebectomies, and eight of them also had ultrasound-guided foam sclerotherapy. Endovenous thermal ablation of saphenous veins was performed in seven patients, whereas two had ligation and stripping. There were four minor postoperative complications in four patients, all of which resolved within 6weeks. The median follow-up was 21months, ranging from 3 to 52months. There were no recurrences of a PVA. Five patients preferred conservative treatment. The diameter changed from 0 to 13mm during the follow-up, and the patients' symptoms remained the same or had mild worsening. PVAs are rare without causing significant symptoms locally. Diagnosis is made with duplex ultrasound because the affected vein is located below the deep fascia. As only one case in our series of 19 involved the deep veins, we believe that PVAs originate from superficial veins. The condition is relatively benign, and the treatment outcomes are very good with limited complications experienced. However, selective treatment of PVAs may not be needed for most of them as treatment of the superficial veins connecting with the PVA may be sufficient.

Retrograde passage of radiofrequency catheter for the endovenous ablation of the great saphenous vein: a modified technique and report of two cases

Corresponding author: Cemal Kemaloglu, M.D. Turgutlu Devlet Hastanesi Kalp ve Damar Cerrahisi Klinigi, 45400 Turgutlu, Manisa, Turkey. Tel: +90 505 899 07 39 e-mail: cemalkemaloglu@hotmail.com This is the report of two cases who underwent a modified great saphenous vein (GSV) ablation for venous insufficiency. For two patients with venous insufficiency and GSV ref lux, radiofrequency (RF) ablation was scheduled. Both patients were obese and they had a ref lux time more than four seconds in erect position with Valsalva’s maneuver during color duplex ultrasound (US). Puncture for the GSV below or above the knee was unable to be performed. For both patients, a successful approach to GSV was made from the saphenofemoral junction (SFJ) at the groin level and GSV was ablated from below the knee level to the SFJ by RF.

Side effects and occlusion rate after tumescentless treatment of the great saphenous vein with EVLA

SummaryWe have performed a retrospective analysis of side-effect profile of endovenous laser ablation (EVLA) of great saphenous veins in patients operated on in general sedation or general/regional anesthesia with or without tumescence solution injection. The results confirmed our initial assumptions that omitting tumescence (and in addition, avoiding any external compression and cooling) may actually significantly reduce the incidence of moderate/severe postoperative pain and brusing without compromising closure rates. As these are probably caused by vessel wall perforations they seem to be more common in the tumescence cohort. The results are in line with recent basic research which showed that fiber tip centering may reduce perforations (easier to perform in vessels filled with blood), that blood itself does not either reduce or enhance laser‘s effect, and that various lasers over a wide range of wavelengths (from hemoglobin-absorbing to water-absorbing) have comparable clinical efficacy. Hence, omitting tumescence and external compression probably reduces the incidence of postoperative pain and brusing in patients treated with EVLA.

Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose)

Whereas thermal ablation of incompetent saphenous veins is highly effective, all heat-based ablation techniques require the use of perivenous subfascial tumescent anesthesia, involving multiple needle punctures along the course of the target vein. Preliminary evidence suggests that cyanoacrylate embolization (CAE) may be effective in the treatment of incompetent great saphenous veins (GSVs). We report herein early results of a randomized trial of CAE vs radiofrequency ablation (RFA) for the treatment of symptomatic incompetent GSVs. Two hundred twenty-two subjects with symptomatic GSV incompetence were randomly assigned to receive either CAE (n = 108) with the VenaSeal Sapheon Closure System (Sapheon, Inc, Morrisville, NC) or RFA (n = 114) with the ClosureFast system (Covidien, Mansfield, Mass). After discharge, subjects returned to the clinic on day 3 and again at months 1 and 3. The study's primary end point was closure of the target vein at month 3 as assessed by duplex ultrasound and adjudicated by an independent vascular ultrasound core laboratory. Statistical testing focused on showing noninferiority with a 10% delta conditionally followed by superiority testing. No adjunctive procedures were allowed until after the month 3 visit, and missing month 3 data were imputed by various methods. Secondary end points included patient-reported pain during vein treatment and extent of ecchymosis at day 3. Additional assessments included general and disease-specific quality of life surveys and adverse event rates. All subjects received the assigned intervention. By use of the predictive method for imputing missing data, 3-month closure rates were 99% for CAE and 96% for RFA. All primary end point analyses, which used various methods to account for the missing data rate (14%), showed evidence to support the study's noninferiority hypothesis (all P < .01); some of these analyses supported a trend toward superiority (P = .07 in the predictive model). Pain experienced during the procedure was mild and similar between treatment groups (2.2 and 2.4 for CAE and RFA, respectively, on a 10-point scale; P = .11). At day 3, less ecchymosis in the treated region was present after CAE compared with RFA (P < .01). Other adverse events occurred at a similar rate between groups and were generally mild and well tolerated. CAE was proven to be noninferior to RFA for the treatment of incompetent GSVs at month 3 after the procedure. Both treatment methods showed good safety profiles. CAE does not require tumescent anesthesia and is associated with less postprocedure ecchymosis.

One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Stanisić M, Węgrzynowski A, Pawlaczyk-Gabriel K. One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein. Phlebological Review. 2015;23(4):102-105. doi:10.5114/pr.2015.59018. APA Stanisić, M., Węgrzynowski, A., & Pawlaczyk-Gabriel, K. (2015). One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein. Phlebological Review, 23(4), 102-105. https://doi.org/10.5114/pr.2015.59018 Chicago Stanisić, Michal-Goran, Adam Węgrzynowski, and Katarzyna Pawlaczyk-Gabriel. 2015. "One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein". Phlebological Review 23 (4): 102-105. doi:10.5114/pr.2015.59018. Harvard Stanisić, M., Węgrzynowski, A., and Pawlaczyk-Gabriel, K. (2015). One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein. Phlebological Review, 23(4), pp.102-105. https://doi.org/10.5114/pr.2015.59018 MLA Stanisić, Michal-Goran et al. "One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein." Phlebological Review, vol. 23, no. 4, 2015, pp. 102-105. doi:10.5114/pr.2015.59018. Vancouver Stanisić M, Węgrzynowski A, Pawlaczyk-Gabriel K. One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein. Phlebological Review. 2015;23(4):102-105. doi:10.5114/pr.2015.59018.

Comparison of 1470 nm Laser and Radial 2ring Fiber with 980 nm Laser and Bare-Tip Fiber in Endovenous Laser Ablation of Saphenous Varicose Veins: A Multicenter, Prospective, Randomized, Non-Blind Study.

The aim of this study is to compare the clinical efficacy and safety of two laser wavelengths and fiber types in endovenous laser ablation (EVLA) of saphenous varicose veins of the lower limb. Multi-center prospective randomized non-blind clinical trial. From January 2007 to December 2011, 113 patients (113 limbs) with primary varicose veins were randomized into two groups. They were treated with radial 2ring fiber and 1470 nm laser in Group I (57 limbs) and bare-tip fiber and 980 nm laser in Group E (56 limbs) in order to ablate the saphenous vein. Vein occlusion rates at 12 weeks and pain in treated region were recorded as primary endpoint. Visual analogue scale (VAS) for assessment of pain, rates of bruising, complications and equipment failure were recorded as secondary endpoint of safety. Occlusion rates at 12 weeks were 100% in both groups. Rates of pain (0% vs. 25.0%) and bruising (7.0% vs. 57.1%) were significantly lower in Group I (p <0.0001). VAS of pain was significantly lower on postoperative day 1, day 5 and 2nd week in Group I. Treatment of saphenous varicose veins by EVLA using a 1470 nm laser and a radial 2ring fiber resulted in comparable occlusion rates at 12 weeks and less postoperative pain and bruising than EVLA with a 980 nm laser and a bare-tip fiber. (This article is a translation of Jpn J Vasc Surg 2014; 23: 964-971.).