Endovenous Laser Ablation of Varicose Veins: Review of Current Technologies and Clinical Outcome

Vascular ◽  
2007 ◽  
Vol 15 (5) ◽  
pp. 250-254 ◽  
Author(s):  
Colleen M. Johnson ◽  
Robert B. McLafferty
Keyword(s):  
Saphenous Vein ◽  
Laser Energy ◽  
Varicose Veins ◽  
Adult Population ◽  
Causative Factor ◽  
Clinical Results ◽  
Effective Treatment Option ◽  
Vein Thrombosis ◽  
Saphenous Nerve Injury ◽  
Deep Vein

Symptomatic lower extremity varicose veins represent one of the most common vascular conditions in the adult population. Associated symptoms ranged from mild conditions such as fatigue, heaviness, and itching to more serious conditions such as skin discoloration and leg ulceration. The predominant causative factor of this condition is reflux of the great saphenous vein (GSV), which is traditionally treated with surgical saphenofemoral ligation and stripping of the incompetent saphenous vein. In recent years, there have been significant advances in saphenous vein ablation using percutaneous techniques, including the endovenous laser therapy (EVLT). In this article, the authors discuss the therapeutic evolution of this technology, theoretical basis of laser energy in GSV ablation, and procedural techniques of EVLT using duplex ultrasonography. Additional discussion of procedural-related complications, such as deep vein thrombosis, skin burn, saphenous nerve injury, and phletibis, and ecchymosis, are provided. Lastly, clinical results of EVLT in GSV ablation are discussed. Current literatures support EVLT as a safe and effective treatment option for varicosities caused by GSV incompetence.

scholarly journals Vein Glue VenaSeal® for the Therapy in Case of Varicose Vein Thrombosis: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Zierau UT
Keyword(s):  
Deep Vein Thrombosis ◽  
Case Report ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Rare Complication ◽  
Vein Thrombosis ◽  
Saphenous Veins ◽  
Deep Vein

The thrombosis in areas of the superficial truncal varicose veins and cutaneous veins is not a rare complication; it requires drug or surgical therapy if the thrombosis grows in the direction of deep veins. This situation is particularly striking in the case of thromboses of the great saphenous vein GSV and small saphenous vein SSV as well as other saphenous veins and leads to deep vein thrombosis in around 20% of cases. We will report about a case of SSV thrombosis and the catheter-based therapy of thrombosis following the therapy of truncal varicose vein SSV with VenaSeal® in one session.

scholarly journals Foam Sclerotherapy and Laser Ablation of Varicose Veins: Newer Option in Bangladesh Perspective

2018 ◽  
Vol 10 (2) ◽  
pp. 140-144
Author(s):  
Motiur Rahman Sarkar ◽  
Nazmul Hosain ◽  
Fazle Maruf ◽  
MA Quaiyum Chowdhury ◽  
Anisuzzaman ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Adult Population ◽  
Leg Pain ◽  
High Ligation ◽  
Foam Sclerotherapy ◽  
Effective Treatment Option

Background: Varicose vein is one of the most common vascular conditions in the adult population. These are conventionally treated with surgical high ligation of Sapheno-femoral junction and stripping of Great Saphenous Vein (GSV) with multiple phlebectomy. The aim of this study was to highlight the technical considerations in performing endovenous laser ablation of varicose vein, understanding the importance and role of Duplex Machine and Tumescent anesthesia with evaluation of outcome.Methods: In this retrospective study we examined the records of 297 limbs of 220 patients operated at Vascular Care Centre at Dhaka, Bangladesh between October 2013 and October 2015. Among them 1 year follow up was performed in 118 patients. Patients were contacted through telephone calls and mobile SMSs with requests for follow up.Results: Vast majority of the patients had a smooth recovery. Significant pain was present in only 10% of patients for 1week after laser therapy and 3% of patients noted bruising in thigh for 2 weeks. Among the 118 patients who reported for follow up at 12 months, 113 (96%) showed effective persistent occlusion of GSV.Conclusion: EVLA of varicose vein is gaining popularity day by day in Bangladesh. It has become established as a safe and effective treatment option for varicosities caused by GSV incompetence. Foam sclerotherapy with Sodium tetradecyl sulphate replacing the multiple phlebectomy may be a suitable adjunct. Quick return to normal activities, fewer wound infections, less leg pain and leg bruising are strongly associated with these endovenous techniques compared with Saphenous vein stripping.Cardiovasc. j. 2018; 10(2): 140-144

Experience with radiofrequency closure of varicose veins (VNUS)

2005 ◽  
Vol 20 (2) ◽  
pp. 82-86 ◽  
Author(s):  
S K Das ◽  
N Sahoo ◽  
M Shanaz
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Cost Savings ◽  
General Anaesthetic ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
The One ◽  
Intraoperative Localization ◽  
The Cost ◽  
Deep Vein

Objective: The aim of this study was to reproduce the results of VNUS closure in our setting; to minimize the cost associated with the procedure; and to reduce the need for an experienced ultrasonographer during the procedure. Methods: Over a two-year period, 26 patients (42 limbs) were treated. A VNUS radio-frequency machine was used and assisted by intraoperative localization using Sonosite ultrasound, which was operated by the surgeon. All patients were treated under general anaesthetic. Nine patients were operated as a day case and 17 others stayed overnight. Median follow-up period was seven months. Results: The mean age of the patients was 37 years (range 19–69). Eighteen patients had primary and eight had recurrent varicose veins. Sixteen patients underwent bilateral and 10 underwent the unilateral procedure. Long saphenous vein (LSV) closure was performed in 41 limbs and short saphenous vein closure in two limbs. The LSV was accessed at the ankle in 36 and at knee in three limbs. In two other limbs, groin exploration with retrograde closure of the LSV was achieved. One patient developed numbness at phlebectomy site. None of the patients had deep vein thrombosis and all the treated veins were closed at the one-week scan. In bilateral cases, one catheter was used instead of two for closure in 12 of the 16 limbs. Using our approach, we were able to make a cost savings of £8,600.00. Conclusion: Technical success in radiofrequency vein closure can be achieved without the need for an additional ultrasonographer. We have shown that our approach is safe, effective and less expensive to deliver.

scholarly journals Comparative analysis of short-term outcomes after surgical treatment of varicose disease with endovasal laser obliteration and short stripping

2021 ◽  
Vol 25 (2) ◽  
pp. 55-62
Author(s):  
A. V. Gavrilenko ◽  
M. V. Ananeva ◽  
P. E. Vakhratyan ◽  
A. N. Kosenkov ◽  
M. M. Musaev
Keyword(s):  
Postoperative Pain ◽  
Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Clinical Severity ◽  
Vein Thrombosis ◽  
Venous Clinical Severity Score ◽  
Ultrasound Findings ◽  
Deep Vein

The purpose of this study was to compare outcomes (within six months) after short stripping (SS) and endovenous laser obliteration (EVLO) in patients with varicose veins when analyzing ultrasound findings, postoperative complications, level of postoperative pain, clinical manifestations, and duration of rehabilitation after the intervention. Patients with varicose veins of lower extremities and insufficiency of large saphenous vein valves had either EVLO or SS with miniflebectomy. All patients were examined before surgery and then in 5 days, 10 days and in 1, 3 and 6 months after it. The patients also had clinical examination, ultrasound duplex scanning of their lower extremity veins; Venous Clinical Severity Score (VCSS) was also used for the trial. Pain was assessed during the first 10 days after the surgery using a 10-point pain assessment scale. 156 patients (177 lower extremities) were followed-up for 6 months. As the results of our study showed, endovenous laser obliteration and short stripping were equally effective in eliminating the reflux of the great saphenous vein (GSV). After 6 months of follow-up, the reflux along the medial inflow was noted in one case in SS group; partial GSV recanalization was noted in one case in EVLO group in 3 months, in 3 cases – in 6 months. Besides, despite LMH preventive doses one patient from EVLO group had EHIT II deep vein thrombosis. The obtained outcomes have demonstrated that EVLO and SS have similar effectiveness and safety. No difference has been found between these two types of treatment, except more pronounced postoperative pain and bruising in SS group. Performed care was equally safe and effective in eliminating GSV reflux, in relieving symptoms and eliminating varicose veins as well as in improving the quality of life. Long-term outcomes, especially the rate of relapses depending on the type of intervention, are to be investigated in future trials.

Leech Therapy - A unique treatment in Ayurveda

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Prasadshakti G. Gannur
Keyword(s):  
Blood Circulation ◽  
Skin Diseases ◽  
Varicose Veins ◽  
Blood Stream ◽  
Blood Capillaries ◽  
Analgesic Property ◽  
Vein Thrombosis ◽  
Leech Therapy ◽  
Medicinal Leeches ◽  
Deep Vein

As mentioned in Ayurveda, Rakta itself is life for human being. If it get vitiated (impure) by means of unhealthy food habits and seasonal change is going to induce many disease. There is a unique worm - Leech which is used therapeutically to treat certain diseases induced by impure blood. Medicinal leeches are used for therapeutic purpose; these will suck only impure blood and relieve the symptoms. While sucking leaches leave saliva into the blood stream, which contain many medicinal properties. Out of which Hirudin is the main content which is having very effective anti-coagulant and analgesic property, because of this analgesic property, the process of sucking is painless. Leaches are mainly used in skin diseases as acne, Kusta, Visarpa, recurrent abscess along with these certain diseases which involve impairment of the blood circulation such as varicose veins deep vein thrombosis non healing ulcers and necrosis are also get benefited by leech therapy which improve the blood circulation by stimulating blood capillaries. Hence in this paper the uses of leech therapy are mentioned for the society to get benefited.

scholarly journals Isolated proximal greater saphenous vein thrombosis and the risk of propagation to deep vein thrombosis and pulmonary embolism

2018 ◽  
Vol Volume 14 ◽  
pp. 129-135 ◽  
Author(s):  
Samuel H Kim ◽  
Nimesh Patel ◽  
Kanika Thapar ◽  
Ananda V Pandurangadu ◽  
Amit Bahl
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Saphenous Vein ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Endovenous Ablation of Varicose Veins Experience at Tertiary Neurological Center

2018 ◽  
Vol 1 (2) ◽  
pp. 94-96
Author(s):  
Sandeep Raj Pandey ◽  
George Bush Jung Katwal ◽  
Sharad Hari Gajuryal
Keyword(s):  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Normal Activity ◽  
Vein Thrombosis ◽  
Long Term Follow Up ◽  
Endovenous Thermal Ablation

Introduction: Endovascular ablation of varicose vein either by radiofrequency ablationor laser delivers sufficient thermal energy to incompetent vein segments to produce irreversible occlusion, fibrosis and ultimately disappearance of the vein.Materials and Methods: Three hundred patients with varicosities due to primary or recurrent sapheno-femoral or sapheno-popliteal junction and great or small saphenous veinreflux underwent out-patient and in-patient endovenous thermal ablation between January 2015 to December 2017.The great saphenous vein was ablated from 2-2.5 cm below sapheno-femoral junction to knee and the small saphenous vein was ablated from mid-calf to the sapheno-popliteal junction.Results: Patient returning time to normal activity was 0–1 days returning to normal daily activity were immediately after 4 hours. Duplex ultrasound follow-up (median 3-months) confirmed abolition of sapheno-femoral junction/great saphenous vein and sapheno-popliteal junction/small saphenous vein reflux in all limbs. There were no instances of skin burns or deep vein thrombosis, but, 7 patients developed transient cutaneous numbness involving sural nerve and 1 developed endovenous heat induced thrombosis 3.Conclusions: This is likely to be more effective than conventional surgery, although long-term follow up is required.  Despite being expensive in comparison to open surgery, endovenous thermal ablation is superior in terms of: minimizing pain, avoiding incision, early mobilisation and discharge. Changing the treatment distance from 2 cm to 2.5 cm peripheral to the Deep veins junction may result in a diminished incidence of endovenous heat induced thrombosis 3.

Recurrent varicose veins assessed by colour-coded duplex scanning: own experience

Phlebologie ◽  
2000 ◽  
Vol 29 (03) ◽  
pp. 58-61 ◽  
Author(s):  
G. Madycki ◽  
P. Dabek ◽  
A. Gabrusiewicz ◽  
W. Staszkiewicz
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Preoperative Assessment ◽  
Duplex Scanning ◽  
Group Iii ◽  
Recurrent Varicose Veins ◽  
Long Saphenous Vein ◽  
Group I ◽  
Short Saphenous Vein ◽  
Deep Vein

SummaryAim: Authors performed a retrospective analysis of causes of recurrent varicose veins following surgery. Methods: They evaluated 89 patients (65 women and 24 men, mean age 49.7 years). All patients previously underwent same surgical procedures (long saphenous vein stripping with/without local multiple avulsions). For the purpose of the study, colour/duplex examinations were applied (Siemens Sonoline Elegra unit). Results: Depending on the type and area of recurrent varicose veins, patients were classified into 4 groups. Group I – 22 patients (persistence of varicose tributaries of LSV in thigh or thigh perforator). Group II – 27 patients (recurrence along the LSV in the calf). Group III – 26 patients (recurrence due to left incompetent short saphenous vein). Group IV – 14 patients (isolated incompetent perforators). Authors conclude, that colour-coded duplex scanning is currently a method of choice in the diagnosis of recurrent varicose veins. High incidence of recurrence due to short saphenous vein incompetence should draw particular attention to this vein in the preoperative assessment of venous system. Recurrence of varicose veins at thigh level is not caused by deep vein insufficiency, but is related to inadequate vein surgery or might be linked to the problem of neovascularisation in this area.

Haemodynamic Correction of Varicose Veins (CHIVA): An Effective Treatment?

1996 ◽  
Vol 11 (3) ◽  
pp. 98-101 ◽  
Author(s):  
P. Zamboni ◽  
C.V. Feo ◽  
M. G. Marcellino ◽  
G. Vasquez ◽  
C. Mari
Keyword(s):  
Saphenous Vein ◽  
Continuous Wave ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
Group A ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein ◽  
Group B

Objective: Evaluation of the feasibility and utility of haemodynamic correction of primary varicose veins (French acronym: CHIVA). Design: Prospective, single patient group study. Setting: Department of Surgery, University of Ferrara, Italy (teaching hospital). Patients: Fifty-five patients with primary varicose veins and a normal deep venous system (ultrasonographic criteria) were studied. Interventions: Fifty-five haemodynamic corrections by the CHIVA method described by Franceschi were undertaken. Seven patients were treated for short saphenous vein varices (group A) while 48 patients were treated for long saphenous vein varices (group B). Main outcome measures: Clinical: presence of varices and reduction in symptoms. Duplex and continuous-wave Doppler detection of re-entry through the perforators and identification of recurrences or new sites of reflux. Postoperative ambulatory venous pressure and refilling time measurements. Patients were studied for 3 years following surgery. Results: In group A, 57% short saphenous vein occlusions with no re-entry through the gastrocnemius and soleal veins were recorded. In group B the long saphenous vein thrombosis rate was 10%. In this group 15% of the patients showed persistence of reflux instead of re-entry at the perforators. Early recurrences were also observed. Overall CHIVA gave excellent results in 78% of the patients. Statistically significant ambulatory venous pressure and refilling time changes were recorded ( p<0.001). Conclusions: CHIVA treatment is inadvisable for short saphenous vein varices. Long saphenous vein postoperative thrombosis is related to development of recurrences

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