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Phlebology 2021 Apr 17:2683555211008762. Epub 2021 Apr 17.

Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China.

Objectives: The aim of this study was to systemically review and analyze the efficacy of cyanoacrylate ablation (CA) in comparison with endovenous thermal ablation (ETA) for the treatment of incompetent saphenous veins.

Methods: A systematic literature search was conducted using databases of Pubmed, Embase, and Cochrane Library from the times of their inception to April 2020. Studies were selected based on inclusion and exclusion criteria after assessing the risk of bias in comparative studies with Cochrane and rating quality of evidence with the GRADE methodology. Read More

Angiol Sosud Khir 2021 ;27(1):75-81

Medical Centre of Phlebology and Lymphology "ARD-CLINIC", Krasnodar, Russia.

The authors describe herein a clinical case report regarding a 70-year-old woman presenting with lower-limb varicosity in the system of the great and small saphenous veins, aneurysmal dilatation of the proximal portion of the great saphenous vein, and an open trophic ulcer of the crus with concomitant hypertension and coronary artery disease. Given these factors, she was subjected to endovenous laser coagulation of the great and small saphenous veins, microfoam echosclerotherapy of the distal portion of the trunk of the great saphenous vein and an incompetent perforating vein of the crus, followed by complete obliteration thereof. On POD 7, she developed positive dynamics in the process of healing of the trophic ulcer, and on POD 50 the ulcer healed completely. Read More

PLoS One 2021 7;16(1):e0245275. Epub 2021 Jan 7.

Department of Vascular Surgery, Dermatologikum Hamburg, Hamburg, Germany.

Background: Recurrent varicosities after endovascular laser ablation (EVLA) of the great saphenous vein (GSV) are frequently due to varicose transformed, initially unsealed major ascending tributaries of the saphenofemoral junction (SFJ). Preventive ablation of these veins, especially the anterior accessory saphenous vein, is discussed as an option, along with flush occlusion of the GSV. However, few related data exist to date. Read More

Int J Hyperthermia 2020 ;37(1):1238-1247

Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris, France.

Background: Varicose veins are a common disease that may significantly affect quality of life. Different approaches are currently used in clinical practice to treat this pathology.

Materials And Methods: In thermal therapy (radiofrequency or laser therapy), the vein is directly heated to a high temperature to induce vein wall coagulation, and the heat induces denaturation of the intramural collagen, which results macroscopically in vein shrinkage. Read More

Rozhl Chir 2020 ;99(7):299-303

Introduction: Endovenous Laser Ablation (EVLA) is a common alternative to surgical treatment of varicose veins. The aim of our study was to demonstrate that laser occlusion is durable, that we can treat all patients in a one day setting, even with veins >10mm in diameter, and that multiple EVLAs can be done at the same time.

Methods: In the period from 1/2017 to 12/2019 EVLA was performed in a total of 1551 consecutive patients with varicose veins and ultrasonographically documented venous reflux. Read More

Surgery 2020 11 10;168(5):909-914. Epub 2020 Aug 10.

Department of Vascular Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background: This study investigates the clinical outcomes of endovenous microwave ablation and endovenous laser ablation for varicose veins.

Methods: A total of 139 patients who underwent endovenous microwave ablation and 145 patients who underwent endovenous laser ablation were included in this multicenter study. The clinical outcomes and complications were assessed at 1, 6, and 12 months after the procedure. Read More

Ned Tijdschr Geneeskd 2020 07 30;164. Epub 2020 Jul 30.

Erasmus MC, afd. Dermatologie, Rotterdam.

Endovenous treatment has become the treatment of choice for patients with saphenous varicose veins (great saphenous vein and small saphenous vein). Current thermal treatment modalities are endovenous laser ablation, radiofrequency ablation and steam ablation. These treatments work by heating the vein, causing the vessel to become occluded. Read More

Ann Vasc Surg 2021 Jan 27;70:109-115. Epub 2020 Jun 27.

Division of Vascular Surgery, University of Pittsburgh, Pittsburgh, PA.

Background: Venous leg ulceration (VLU) represents the most advanced form of chronic venous insufficiency (CVI). Persistent VLU that fails to respond to noninvasive treatment requires a minimally invasive endovascular treatment, which may include chemical (ultrasound-guided foam sclerotherapy [UGFS]) and thermal ablation (endovenous laser therapy [EVLT] or radiofrequency ablation [RFA]) targeting incompetent veins. Current guidelines suggest ablation of incompetent perforating veins (IPVs) juxtaposed to active or healed VLU; however, the ideal treatment modality is unknown. Read More

J Vasc Surg Venous Lymphat Disord 2021 03 27;9(2):352-360. Epub 2020 Jun 27.

Department of Surgery, Multidisciplinary Center for Day Surgery, University Hospital of Padua, Padua, Italy.

Objective: Scarce information is available on the long-term results of endovenous laser ablation (EVLA) for great saphenous vein (GSV) or small saphenous vein (SSV) insufficiency. We sought to provide data on the status of patients at least 9 years after EVLA.

Methods: In 2018, we undertook a cross-sectional survey of ambulatory patients who had undergone EVLA in our tertiary care center in 2008-2009. Read More

J Vasc Surg Venous Lymphat Disord 2021 03 26;9(2):329-334. Epub 2020 Jun 26.

Imperial College, London, UK.

Objective: Cyanoacrylate closure of refluxing saphenous veins has demonstrated excellent safety and effectiveness results in feasibility and pivotal studies. This article provides the 36-month follow-up results of a prospective, multicenter, nonrandomized cohort study.

Methods: A total of 70 patients were enrolled in a prospective, multicenter study conducted at seven centers in four European countries and underwent treatment of a solitary refluxing great saphenous vein with endovenous cyanoacrylate embolization without the use of tumescent anesthesia or postprocedure compression stockings. Read More

Angiol Sosud Khir 2020 ;26(2):103-109

Department of Surgery of the South-Urals State Medical University of the Ministry of Healthcare of the Russian Federation, Chelyabinsk, Russia.

Aim: The purpose of the study was to assess efficacy of endovenous laser ablation of major saphenous veins by means of the Mediola single-ring radial light guides with the use of the 'Optical Handpiece MHP02 (Colibri)'.

Patients And Methods: This non-comparative prospective study included 430 consecutive patients who underwent a total of 511 endovenous laser ablation procedures from January 2018 to March 2019. The great saphenous vein was subjected to obliteration in 343 (67. Read More

Med Arch 2020 Apr;74(2):100-104

Department of Radiology, Bach Mai Hospital, Hanoi, Vietnam.

Introduction: Chronic venous insufficiency (CVI) is a chronic condition, triggered by reflux through the saphenous vein network.

Aim: To determine the efficacy of endovenous laser ablation (LA) and radiofrequency ablation (RFA) for CVI treatment in the lower extremities, at the Bach Mai Radiology Center.

Methods: This retrospective study was approved by the institutional review board of Bach Mai Hospital. Read More

Semin Vasc Surg 2020 Mar 12;32(3-4):89-93. Epub 2019 Jun 12.

Department of Surgery, King Saud University, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.

Lower limb varicose veins are a common vascular disorder producing pain and disability when truncal vein reflux is present. Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is a safe and effective method for treating this condition. An unintended complication of this procedure is endothermal heat-induced thrombosis (EHIT) of common femoral vein. Read More

J Vasc Surg Venous Lymphat Disord 2021 01 1;9(1):137-145. Epub 2020 May 1.

Department for Dermatology, Ruhr-University Bochum, Bochum, Germany.

Objective: Although many studies have demonstrated that endovenous therapies have comparable efficacy to crossectomy and stripping, few studies have been published regarding the classification and recurrence patterns of varicose veins after endovenous therapy. This study attempted to provide an objective scheme for the definition and classification of recurrence. Moreover, it describes the types and rates of recurrence after endovenous thermal ablation, as well as factors associated with recurrence. Read More

J Vasc Surg Venous Lymphat Disord 2020 11 19;8(6):1021-1024. Epub 2020 Apr 19.

Vascular Institute of New York, Brooklyn, NY.

Objective: Lower extremity endovenous ablation has become the primary treatment modality for symptomatic venous reflux disease. Endovenous heat-induced thrombosis (EHIT) has been reported as one of the primary complications of these venous ablative procedures. Our aim was to determine how long EHITs take to resolve and the factors affecting this length of time. Read More

J Vasc Surg Venous Lymphat Disord 2020 11 10;8(6):1006-1013. Epub 2020 Apr 10.

Department of Angiology, University Hospital Basel, University of Basel, Basel, Switzerland; Gefässpraxis am See, Lakeside Vascular Center, Lucerne, Switzerland.

Objective: The optimal ablation distance from the catheter tip to the common femoral vein during endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is a matter of debate. In this study, we evaluated the feasibility and safety of flush ablation (fEVLA) of the GSV.

Methods: This single-center, retrospective analysis of prospectively collected data included all consecutive fEVLA interventions of the GSV between September 2017 and October 2018. Read More

Wiad Lek 2020 ;73(2):329-331

Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.

Objective: The aim: To analyze and evaluate the efficacy of CDLLV treatment, using high-frequency endovascular welding (EVW), endovenous laser coagulation (EVLC) and catheter microfoam echosclerotherapy.

Patients And Methods: Materials and methods: We have treated 329 patients with CDLLV C2-C6 functional classes according to the Clinical Etiological Anatomical Pathophysiology. Of these, 102 patients had vertical reflux eliminated by EVW, in 112 - by EVLC, and in 115 - by catheter microfoam echosclerotherapy. Read More

Angiol Sosud Khir 2020 ;26(1):56-61

Clinic of Phlebology and Laser Surgery, Chelyabinsk, Russia.

Aim: The purpose of the present study was to assess the possibility of carrying out endovenous laser obliteration (EVLO) with radial light guides on a laser device operating at a wavelength of 1470 nm, using for tumescence only cold normal saline solution without additional sedation or narcosis in patients with allergy to local anaesthetics.

Patients And Methods: Our prospective non-comparative single-centre study consecutively included 37 patients who from November 2014 to June 2019 underwent a total of 41 isolated EVLO procedures without simultaneous miniphlebectomy or sclerotherapy of tributaries. Given the previous history of allergy to amide-group local anaesthetics and/or multiple allergic reactions to other agents, these patients received as anaesthesia and tumescence exclusively normal saline solution cooled to a temperature of +3-6ºC, without addition of local anaesthetics or any other therapeutic agents, with neither sedation nor narcosis. Read More

J Vasc Surg Venous Lymphat Disord 2020 09 21;8(5):805-813. Epub 2020 Mar 21.

Kabnick Vein Center, Morristown, NJ.

Background: Treatment of pathologic perforator veins (PPVs) can shorten time to healing and reduce recurrence of ulcers in patients with advanced venous disease. Because of limited clinical evidence and device options, widespread adoption of PPV treatment is controversial. The objective of this study was to evaluate the safety and efficacy of endovenous laser therapy using a 400-μm optical fiber to treat PPVs. Read More

Ann Ital Chir 2020 ;91:61-64

Aim: The traditional surgical treatment for lower limb primary varicosity has been for a long time high ligation of sapheno-femoral junction and stripping of great saphenous vein. Surgery, however, has been frustrated by postoperative pains and discomfort and recurrences so that it has been challenged by minimally invasive endovenous techniques such as laser treatment and radiofrequency ablation. The aim of the article is to assess the feasibility, in a day hospital setting, of a combined approach to greater saphenous vein reflux: high ligation of sapheno-femoral junction and thermal treatment of the great sapenous vein. Read More

Int J Hyperthermia 2020 ;37(1):231-244

Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris, France.

Varicose veins are a common pathology that can be treated by endovenous thermal procedures like radiofrequency ablation (RFA). Such catheter-based techniques consist in raising the temperature of the vein wall to 70 to 120 °C to induce vein wall coagulation. Although effective, this treatment option is not suited for all types of veins and can be technically challenging. Read More

Hautarzt 2020 Dec;71(Suppl 2):67-73

Venenzentrum Freiburg, Zähringer Str. 14, 79108, Freiburg, Germany.

Thermal ablation of saphenous vein varicosis has developed into a standard procedure for treatment of varicose veins. The clinical success of the endovenous thermal procedure is comparable to high ligation and stripping operations and a significant difference between these groups could not be detected in long-term analyses. The only difference is in the genesis of saphenofemoral recurrence detected by duplex ultrasound: neoangiogenesis occurs after high ligation and stripping operation and after endovenous ablation of the great saphenous vein a recurrence occurs predominantly via a residual anterior accessory saphenous vein (AASV). Read More

J Vasc Surg Venous Lymphat Disord 2020 07 21;8(4):601-609. Epub 2020 Feb 21.

Division of Vascular Surgery, Department of Surgery, Indiana University, Indianapolis, Ind.

Objective: To evaluate the impact of three treatment modalities, superficial truncal vein ablation, perforator vein ablation, and deep venous stenting on venous leg ulcer (VLU) healing, as well as their cumulative effect on ulcer healing, in an attempt to establish the best algorithm for the treatment of chronic and recalcitrant VLUs.

Methods: Multicenter retrospective cohort study using a standardized database to evaluate patients with chronic venous ulcers treated between January 2013 and December 2017.

Results: Eight-hundred thirty-two consecutive patients with VLU were identified at 11 centers in the United States. Read More

Medicine (Baltimore) 2020 Feb;99(8):e19317

The Department of Vascular and Hernial Surgery, The Ganzhou People's Hospital (The Affiliated Ganzhou Hospital of Nanchang University), Ganzhou, PR China.

Endovenous laser ablation (EVLA) and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced traditional surgery for treatment of varicose veins (VVs) with active venous leg ulcers (VLUs), and multiple combined modes have emerged. A retrospective cohort study was performed to compare the effect of traditional surgery (high ligation and stripping followed with compression [compression plus HL-S]) to high ligation-endovenous laser ablation-foam sclerotherapy followed with compression (compression plus HL-EVLA-FS) on the treatment of active VLUs.Data of active VLUs treated in our center from 2008 to 2017 and followed up for 1 year were analyzed. Read More

J Vasc Surg Venous Lymphat Disord 2020 05 14;8(3):472-481.e3. Epub 2020 Feb 14.

Department of Surgery, Imperial College London, London, United Kingdom.

Objective: Several randomized controlled trials (RCTs) have compared different interventions for chronic venous insufficiency (CVI) management, but mixed comparison of these interventions is lacking. The aim of this network meta-analysis was to compare VenaSeal closure system (Medtronic, Minneapolis, Minn) with endovenous laser ablation (EVLA), radiofrequency ablation (RFA), mechanochemical ablation, sclerotherapy, and surgery for management of CVI to achieve anatomic success (complete closure of treated vein within 6 months after intervention) as the primary outcome and health-related quality of life (HRQoL; EuroQol-5 Dimension, Aberdeen Varicose Vein Questionnaire), Venous Clinical Severity Score (VCSS), pain scores, and adverse events as secondary outcomes.

Methods: A systematic review of journal databases was undertaken, and RCTs between January 1996 and September 2018 comparing different treatment options were included. Read More

G Chir 2019 Sep-Oct;40(5):413-416

Aim: For long time the traditional surgical treatment for lower limb varicose veins has been high ligation of sapheno-femoral junction and stripping of great saphenous vein. Surgery, however, has been frustrated by postoperative pains, discomfort and recurrences so that it has been challenged by minimally invasive endovenous techniques such as laser treatment and radiofrequency ablation. The aim of the article is to assess the feasibility of a combined approach to greater saphenous vein reflux: high ligation of sapheno-femoral junction and thermal treatment of the great saphenous vein. Read More

Wiad Lek 2019 Aug;72(8):1447-1452

Shupyk National Medical Academy Of Postgraduate Education, Kyiv, Ukraine

Introduction: Acute ascending thrombophlebitis (AAT) of the great saphenous vein (GSV) is one of the problems in modern surgery.

The Aim: Study of morphological and ultrasonic changes in a thrombosed vein following the influence of high-frequency endovenous electrical welding and assessment of the efficacy of application of this method to treatment of acute ascending thrombophlebitis.

Material And Methods: During the period of 2016-2018, surgery departments of Kyiv City Hospital No. Read More

Adv Ther 2020 02 24;37(Suppl 1):6-12. Epub 2020 Jan 24.

Jobst Vascular Institute, Toledo, OH, USA.

Contemporary interventional treatment of primary chronic venous disease (CVD) is mainly focused on the treatment of venous reflux. The long-term results of endovenous ablation (EVA) and high ligation and stripping are not different with respect to varicose vein recurrence, and this recurrence appears to be a manifestation of disease progression. Since inflammation is one of the key mechanisms of CVD development and progression, efforts to minimize inflammation and angiogenic potential in endovenous and surgical procedures are worthwhile. Read More