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PLoS One 2022 15;17(2):e0263513. Epub 2022 Feb 15.

Division of Transplantation and Vascular surgery, Department of Surgery, Hanyang University Medical Center, Seoul, Korea.

Three-dimensional computed tomography venography is a useful tool to identify increased saphenous vein diameter and provides a complementary road map for surgery in patients with varicose veins. In this study, we investigated the correlation between saphenous vein diameter on computed tomography venography and venous reflux detected on duplex ultraonography. We enrolled 152 patients (213 extremities) who underwent endovenous laser ablation therapy, following high ligation of the saphenofemoral junction between January 2014 and December 2019. Read More

Med Eng Phys 2022 02 23;100:103745. Epub 2021 Dec 23.

Computer Science Department, Institute of Space and Information Technologies, 660074, 26 Kirensky str., Krasnoyarsk, Russia.

The article describes the research of a new treatment method of lower limb varicose vein using low-frequency ultrasound. To study the effectiveness of this method we analyzed the interaction between the ultrasound instrument and the venous wall and defined the mechanisms of action during endovenous ultrasound treatment (EUT): thermal, mechanical, and chemical. We developed three models to study the impact of different combinations of mechanisms of action on varicose venous wall. Read More

Phlebology 2022 Apr 4;37(3):223-225. Epub 2022 Jan 4.

Laboratory of Research in Vascular Surgery, 9354IRCCS Istituto Auxologico Italiano, Milan, Italy.

Quality of life (QoL) in patients with chronic venous disorders has a central role to decide the correct treatment approach. In particular, in case of mini-invasive therapy, such as endovenous radiofrequency ablation (RFA), the postoperative QoL improvement remains one of the most important outcome to be reached. Despite this, very few data are published on the long-term QoL modifications after RFA. Read More

Dermatol Ther 2022 Apr 27;35(4):e15322. Epub 2022 Jan 27.

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Endovenous thermal and non-thermal therapeutic approaches have become standard of care for the treatment of venous insufficiency. However, comparative studies on its use in the population of venous leg ulcer patients are scarce. The present study aimed at a comparison of the efficacy of endovenous laser ablation (EVLA) and ultrasound-guided foam sclerotherapy (UGFS) for the treatment of venous leg ulcers (VUs). Read More

Eur Rev Med Pharmacol Sci 2021 Dec;25(24):7777-7786

Department of Vascular Surgery, Hauzer Clinic LLC LP, Żerniki Wrocławskie, Poland.

Objective: Surgical treatment of chronic venous insufficiency (CVI) includes sclerotherapy, cryosurgery, CHIVA method (from the French for ambulatory conservative hemodynamic treatment venous insufficiency), chemical and mechanical obliteration, or phlebectomy. A hybrid treatment that combines sclerotherapy with endovenous laser ablation (EVLA) at 980 nm or 1470 nm or Nd:YAG laser at 1064 nm is also increasingly used. This paper synthesizes the current knowledge of CVI of the lower limbs and demonstrates promising clinical practice experiences using a hybrid method that combines EVLA with intraoperative or postoperative ultrasound-guided foam sclerotherapy (UGFS), also known as echosclerotherapy. Read More

Phlebology 2022 Apr 30;37(3):165-179. Epub 2021 Dec 30.

Department of Surgery, 1140Northwest Clinics, Alkmaar, The Netherlands.

Objective: To investigate and compare the outcomes of the available treatment modalities for anterior accessory saphenous vein (AASV) incompetence.

Methods: A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Studies reporting the outcomes of patients who were treated for primary AASV incompetence were included. Read More

Ann Vasc Surg 2022 May 18;82:7-12. Epub 2021 Dec 18.

Division of Vascular and Endovascular Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA; Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, CA.

Background: Endovenous ablation techniques have replaced greater saphenous vein (GSV) ligation and stripping for treatment of venous insufficiency. Our objective was to investigate our initial procedural experience and clinical presentation of patients undergoing mechanochemical ablation (MOCA) at a single institution. We hypothesized that closure level and success rate improved over time and were comparable to other endovenous ablation techniques. Read More

Lasers Surg Med 2022 04 5;54(4):511-522. Epub 2021 Dec 5.

Laser Research Laboratory, LIFE Center, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.

Objectives: To evaluate the safety, efficacy and ≥36 months outcomes of endovenous laser ablation (EVLA) by means of 1940 nm laser with radial fiber for the treatment of truncal vein insufficiency and compare the results to a historical cohort, obtained via reviewing the literature.

Methods: This prospective, non-randomized, single-center clinical study included 139 consecutive patients with 177 incompetent great saphenous (GSV, n = 135) and short saphenous veins (SSV, n = 42). The maximum laser power (Pmax. Read More

Dermatol Ther 2022 02 13;35(2):e15238. Epub 2021 Dec 13.

1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Chronic venous disorder (CVD) is highly prevalent vascular disorder affecting up to 45% of the general population, with clinical manifestations ranging from teleangiectasias to venous leg ulcers (VLUs). We examined the currently available data in order to provide an updated, comprehensive review on treatment options of CVD. We searched MEDLINE, Cochrane, Scopus, EMBASE, ClinicalTrials, and OpenGrey databases for relevant articles in English published until November 2020. Read More

Ann Vasc Surg 2022 Mar 12;80:313-324. Epub 2021 Nov 12.

Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia.

Introduction: Cyanoacrylate embolization (CAE) is a novel non-thermal non-tumescent venous ablation technique that has shown promising results in treating saphenous vein insufficiency. We aimed to assess the efficacy and safety profile of CAE in comparison to endovenous laser ablation (EVLA) in treating saphenous vein insufficiency.

Material And Methods: We conducted a systematic review and meta-analysis in accordance with the PRISMA Statement. Read More

Ann Vasc Surg 2022 Mar 11;80:302-312. Epub 2021 Nov 11.

Department of Vascular Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences and Tongji Shanxi Hospital, Tongji Medical College of HUST, Taiyuan, China. Electronic address:

Objective: A systematic review and meta-analysis were performed to evaluate the necessity for compression therapy with elastic stockings following endovenous thermal ablation (EVTA) for chronic venous insufficiency.

Methods: MedLine, ScienceDirect and the Cochrane Library were searched for the relevant literature according to the inclusion and exclusion criteria. Two researchers independently extracted data and assessed the quality of the literature. Read More

J Lasers Med Sci 2021 19;12:e50. Epub 2021 Sep 19.

Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Currently, lasers are used to treat many diseases and their complications. However, the use of lasers in pregnant patients is still controversial. In this review, the application of lasers in the fields of urology, surgery, obstetrics, dermatology, and musculoskeletal disorders is evaluated. Read More

Zhonghua Yi Xue Za Zhi 2021 Oct;101(39):3232-3237

Department of Vascular Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.

To explore the efficacy of endovenous microwave ablation in treating primary varicose veins of the lower extremities. A total of 214 patients with primary varicose veins of the lower extremities in the First Affiliated Hospital of Sun Yat-sen University from January 2017 to November 2019 were included and divided into microwave ablation group (=128) and high ligation with microwave ablation group (=86) according to surgical approach. Further subgroups including subgroup S (diameter<10 mm) and subgroup L (diameter≥10 mm) were established. Read More

Lasers Med Sci 2022 Apr 23;37(3):1899-1906. Epub 2021 Oct 23.

The Whiteley Clinic, Stirling House, Stirling Road, Guildford, GU2 7RF, Surrey, UK.

Current endovenous laser ablation (EVLA) practice favours 1470 nm, as water is a major chromophore for this wavelength. Water has a greater affinity for 1940 nm, leading to claims that lower powers or linear endovenous energy densities (LEEDs) are needed. We compared the thermal spread and carbonisation of EVLA using these two wavelengths, in the porcine liver model. Read More

Cochrane Database Syst Rev 2021 09 30;9:CD009648. Epub 2021 Sep 30.

Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.

Background: Many surgical approaches are available to treat varicose veins secondary to chronic venous insufficiency. One of the least invasive techniques is the ambulatory conservative hemodynamic correction of venous insufficiency method (in French 'cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire' (CHIVA)), an approach based on venous hemodynamics with deliberate preservation of the superficial venous system. This is the second update of the review first published in 2013. Read More

J Vasc Surg Venous Lymphat Disord 2022 May 24;10(3):749-757. Epub 2021 Sep 24.

Physics and Chemistry Institute, National Research Ogarev Mordovia State University, Saransk, Russia.

Objective: To determine the morphological changes in veins and perivenous tissues after endovenous laser coagulation (EVLC) using laser radiation with a wavelength of 1910 nm and different types of fibers (bare tip and radial).

Methods: The EVLC procedure was carried out on 22 surface veins of six sheep. The radiation source was a diode-pumped solid-state laser, which was based on a LiYF:Tm crystal and had an emission wavelength of 1910 nm and a maximum output power of 10 W. Read More

JNMA J Nepal Med Assoc 2021 Mar 31;59(235):267-270. Epub 2021 Mar 31.

Department of Cardiothoracic and Vascular Surgery (CTVS), National Academy of Medical Sciences, Bir Hospital, Mahabauddha, Kathmandu, Nepal.

Introduction: Varicosity is the common problem of various etiology having simple limb aching to worst complications like oedema, ulcer, and skin changes. Minimal invasive endovenous laser therapy is a noble procedure. The aim of the study is to find out the recurrence of the varicose vein after laser therapy in a tertiary care center. Read More

J Vasc Surg Venous Lymphat Disord 2022 May 25;10(3):646-653.e1. Epub 2021 Aug 25.

Department of Phlebology, Skin and Vein Clinic Oosterwal, Alkmaar, The Netherlands.

Objective: The long-term results of saphenofemoral ligation and stripping (SFL/S) were compared with 980-nm bare fiber endovenous laser ablation (EVLA) for the treatment of great saphenous vein (GSV) incompetence.

Methods: This was a single-center, randomized, controlled trial with a follow-up time of 10 years. Patients with GSV incompetence were randomized to undergo SFL/S or EVLA under tumescent anesthesia. Read More

J Vasc Surg Venous Lymphat Disord 2022 03 25;10(2):504-513.e7. Epub 2021 Aug 25.

Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK; Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK. Electronic address:

Objective: To analyze the effectiveness and cost effectiveness of technologies for treatment of varicose veins over 5 years-conservative care, surgery (high ligation and stripping), ultrasound-guided foam sclerotherapy (UGFS), endovenous laser ablation (EVLA), and radiofrequency ablation (RFA), mechanochemical ablation (MOCA), and cyanoacrylate glue occlusion (CAE).

Methods: A systematic review was updated and used to construct a Markov decision model. Outcomes were reintervention on the truncal vein, retreatment of residual varicosities and quality-adjusted life years (QALY) and costs over 5 years. Read More

J Vasc Surg Venous Lymphat Disord 2022 May 24;10(3):654-660. Epub 2021 Aug 24.

Center for Vein Restoration, Greenbelt, Md. Electronic address:

Objective: Endovenous therapies are currently the standard of care for the treatment of patients with symptomatic great saphenous vein (GSV) reflux. The effectiveness and long-term outcomes of these therapies for anterior accessory great saphenous veins (AAGSVs) are poorly defined. The objective of this investigation is to determine treatment outcomes in patients with symptomatic AAGSV reflux compared with patients with symptomatic GSV reflux. Read More

J Vasc Surg Venous Lymphat Disord 2022 03 24;10(2):370-375. Epub 2021 Aug 24.

Department of Health, District Medical Office (Health), Malappuram, India.

Background: Technical errors are the most common preventable cause of recurrence after high ligation and stripping procedures for the treatment of great saphenous vein incompetence. Ultrasound-assisted varicose vein surgery (UAVS) uses intraoperative ultrasound during high ligation and stripping to minimize such failures, although no data have been reported regarding its use during open surgery. The present study compared the short-term outcomes of UAVS and endovenous laser ablation (EVLA) with a 1470-nm laser. Read More

J Vasc Surg Venous Lymphat Disord 2022 01 10;10(1):75-81.e1. Epub 2021 Jul 10.

Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan.

Objective: We compared the safety, need for additional foam sclerotherapy, and 1-year venous clinical severity score (VCSS) improvement in the limbs of patients with chronic venous disease and great saphenous vein (GSV) reflux. These patients had undergone endovenous laser ablation (EVLA) using a 1470-nm diode laser and concurrent foam sclerotherapy (1% polidocanol) through the access sheath (transluminal injection of foam sclerotherapy [TLFS]) or EVLA and concurrent direct-puncture ultrasound-guided foam sclerotherapy (UGFS).

Methods: In the present study, we screened 467 patients (577 legs) with symptomatic primary GSV reflux for randomization to either TLFS with EVLA (n = 103 legs; TLFS group) or UGFS with EVLA (n = 94 legs; UGFS group). Read More

Ann Vasc Dis 2021 Jun;14(2):122-131

Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Fukuoka, Japan.

To investigate the optimal duration of compression therapy after endovenous laser ablation (EVLA) using a 1470-nm diode dual-ring radial laser fiber for great saphenous vein (GSV) insufficiency. Patients undergoing EVLA of GSV for varicose vein disease were divided into two groups based on the duration of subsequent compression after the procedure: short duration group (S group; 0-2 days) and long duration group (L group; 1-4 weeks). Patient-reported outcomes (pain and quality of life [QOL]) were set as the primary outcomes, and objective findings (venous clinical severity score [VCSS], leg circumference, and duplex ultrasound [DUS] findings) were set as the secondary outcomes. Read More

Ont Health Technol Assess Ser 2021 4;21(8):1-188. Epub 2021 Jun 4.

Background: Varicose veins are part of the spectrum of chronic venous disease and are a sign of underlying chronic venous insufficiency. Treatments to address varicose veins include surgical vein removal under general anesthesia, or endovenous laser (EVLA) or radiofrequency ablation (RFA) under tumescent anesthesia. Two newer nonthermal endovenous procedures can close veins without any tumescent anesthesia, using either mechanochemical ablation (MOCA, a combination of mechanical and chemical techniques) or cyanoacrylate adhesive closure (CAC). Read More

Surg Technol Int 2021 06;39:267-271

Sanalink, The Netherlands.

Objective: A critical appraisal of the original procedure of endovenous laser ablation (EVLA) for varicose veins.

Method: Evaluation of all practical aspects of the procedure.

Results: EVLA procedures are performed in a strictly ambulatory setting with tumescent local anesthesia (TLA). Read More

J Vasc Surg Venous Lymphat Disord 2021 07;9(4):1057

Penn State Heart and Vascular Institute, Penn State College of Medicine, Hershey, Pa.

Georgian Med News 2021 Apr(313):26-33

4Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russian Federation.

The aim of the study is to substantiate the surgical treatment tactics of recurrence varicose veins after endovenous interventions. Early and long-term results of the treatment, quality of life of patients with recurrence of varicose veins were studied. Among the admitted patients, there were 55 (65. Read More

Int Angiol 2021 Aug 19;40(4):277-282. Epub 2021 May 19.

United Vein and Vascular Centers, Tampa, FL, USA.

There remain many questions regarding the pathophysiology and risk factors for endothermal heat induced thrombosis formation. Moreover, there are a paucity of data on the timing of its occurrence, and there has been no consensus regarding for its treatment. The purpose of this review was to summarize the current knowledge on the pathophysiology, risk factors and treatment strategies for endothermal heat induced thrombosis. Read More

J Vasc Surg Venous Lymphat Disord 2021 11 3;9(6):1517-1525. Epub 2021 May 3.

Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, China; Vascular Centre of Shanghai JiaoTong University, Shanghai, China. Electronic address:

Objective: We evaluated the clinical outcomes of superficial and perforator ablation and the effects on wound healing by adding iliac vein stenting of nonthrombotic iliac vein lesions (NIVLs) in patients presenting with active venous ulcers.

Methods: A retrospective analysis was performed of patients who had presented with venous ulcers and had a diagnosis of NIVLs from January 2017 to December 2019. Patients with a >50% diameter reduction in the iliac vein as determined by computed tomography venography had undergone transfemoral venography for further confirmation. Read More

Phlebology 2021 Sep 28;36(8):659-664. Epub 2021 Apr 28.

Department of Cardiovascular Surgery, Center of Varicose Veins, Okamura Memorial Hospital, Shizuoka, Japan.

Objective: We evaluated the benefit of local anesthesia including tumescent anesthesia and active walking soon after surgery in preventing nerve injury and deep vein thrombosis caused during endovenous ablation.

Methods: Endovenous ablation was performed in 1334 consecutive patients. Varicectomy was performed using the stab avulsion technique. Read More