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J Vasc Surg Venous Lymphat Disord 2020 Apr 30. Epub 2020 Apr 30.

Department for Dermatology, Ruhr-University 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

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

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

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

Cureus 2020 Jan 13;12(1):e6643. Epub 2020 Jan 13.

Vascular Surgery, King Saud Bin Abdulaziz University for Health Sciences (ksau-Hs), Riyadh, Saudi Arabia, Riyadh, SAU.

Background: Venous reflux most frequently occurs in the great saphenous vein (GSV), which is the most commonly diseased vein and is associated with venous insufficiency and varicose veins.

Objective: We aimed, in this study, to determine risk factors for saphenous vein insufficiency in female patients in Riyadh, Saudi Arabia.

Methods: This was a retrospective cohort study. Read More

Swiss Med Wkly 2019 Dec 23;149:w20166. Epub 2019 Dec 23.

Department of Angiology, University Hospital and University of Basel, Switzerland / Gefässpraxis am See - Lakeside Vascular Centre, Lucerne, Switzerland.

Aim Of The Study: The objective of this study was to identify the optimal duration of pharmacological thromboprophylaxis after outpatient endovenous laser ablation (EVLA).

Methods: In this multicentre retrospective study in a university hospital, regional hospital and private practices, we collected the demographic, procedural and outcome data of all consecutive patients with varicose veins class C2 to C6 undergoing outpatient EVLA of truncal and accessory veins between February 2009 and December 2015. The cumulative primary efficacy endpoint consisted of endovenous heat-induced thrombosis (EHIT) class 2–4, deep vein thrombosis (DVT) and pulmonary embolism (PE) diagnosed with duplex ultrasound or computed tomography angiography after 1 and 4 weeks of follow-up. Read More

Hautarzt 2020 Jan;71(1):12-19

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

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 Mar 14;8(2):216-223. Epub 2019 Dec 14.

Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md. Electronic address:

Background: Varicose vein ablation procedures are being performed with increasing frequency; however, there is a lack of consensus on the relative efficacy of combined treatment of saphenous incompetence and symptomatic varicosities vs a staged approach. In this study, we examined the impact on symptom severity when a procedure to eliminate varicosities was added to standard endovenous saphenous ablation.

Methods: The Varicose Vein Module of the American Venous Registry was established by the American Venous Forum in 2010 and collected data from 48 physicians during a 5-year period. Read More

J Vasc Surg Venous Lymphat Disord 2020 Jan 5;8(1):74-83. Epub 2019 Nov 5.

Department of Vascular Surgery, Zhongshan Hospital, Affiliated to Fudan University, Shanghai, People's Republic of China; Department of Vascular Surgery, Qingpu Branch of Zhongshan Hospital, Affiliated to Fudan University, Shanghai, People's Republic of China. Electronic address:

Background: Lower limb chronic venous disease (CVD), resulting from iliac vein compression syndrome (IVCS), manifests as a series of symptoms ranging from varicose veins to venous ulcerations. Stent implantation has been considered an effective treatment method; however, the management of CVD has rarely been reported. In the present study, we evaluated the treatment and outcomes of patients with CVD. Read More

Ann Ital Chir 2019 ;90:457-462

Purpose: Superficial venous insufficiency is a common problem associated with varicose veins. In addition to classical symptoms, it may result in skin changes, venous ulcers and has a great impact on patients' health-related quality of life. In the last decade, minimally invasive techniques such as endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) have been developed as alternatives to surgery in an attempt to reduce morbidity and improve efficiency. Read More

Acta Chir Belg 2019 Oct 25:1-8. Epub 2019 Oct 25.

Department of Cardiovascular Surgery, Karabük Training and Research Hospital , Karabuk , Turkey.

We aimed to investigate the efficacy and safety of five different treatment approaches in patients with a great saphenous vein (GSV) diameter of ≥10 mm. A total of 697 extremities of 671 patients who were diagnosed with a GSV diameter of ≥10 mm underwent conventional surgery or endovenous therapy for symptomatic varicose veins between January 2012 and January 2017 were included in this retrospective study. All extremities included in the study were divided into five groups as follows: high ligation + stripping (HLS), radiofrequency ablation (RFA), cyanoacrylate closure (CAC), endovenous laser ablation (EVLA) procedures at 980 nm and 1,470 nm wavelengths. Read More

J Vasc Surg Venous Lymphat Disord 2019 11 17;7(6):817-823. Epub 2019 Sep 17.

Department of Cardiovascular Surgery, Fukushima Daiichi Hospital, Fukushima, Japan.

Objective: A nationwide survey was conducted in Japan to determine the incidence of venous thromboembolism (VTE) after endovenous thermal ablation for varicose veins and to investigate its pathogenic background.

Methods: The survey targeted all cases of endovenous thermal ablation between January 2011 and December 2013. Based on this survey, a retrospective study of patients who developed endovenous heat-induced thrombosis (EHIT) of classes 2 to 4, no EHIT-related deep venous thrombosis (DVT), and pulmonary embolism (PE) was conducted. Read More

N Engl J Med 2019 09;381(10):912-922

From the Institute of Cardiovascular Research, University of Glasgow (J.B.), and the Institute of Applied Health Research, Nursing, Midwifery, and Allied Health Professions Research Unit, Glasgow Caledonian University (A.E.), Glasgow, the Health Services Research Unit (D.C., S.C.C., G.M., C.R.R., M.K.C.) and the Health Economics Research Unit (M.D., G.S., E.T.), University of Aberdeen, and the Department of Vascular Surgery, NHS Grampian, Aberdeen Royal Infirmary (P.B.), Aberdeen, the Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh (J.N.), the School of Medicine, Medical and Biological Sciences, University of St. Andrews, St. Andrews (J.M.B.), the Department of Vascular Surgery, Royal Devon and Exeter Hospital, Exeter (B.C.), the Department of Vascular Surgery, Hull Royal Infirmary, Hull (I.C.), the School of Surgery, University of Leeds (M.G.), and Vascular Surgery, St. James University Hospital (J.S.), Leeds, Vascular Surgery, Gloucestershire Royal Hospital, Gloucester (J.E.), Vascular Surgery, Freeman Hospital, Newcastle upon Tyne (T.L.), the Vascular Surgical Unit, Royal Bournemouth Hospital, Bournemouth (S.A.B.), and the School of Health Sciences, City University of London, London (J.F.) - all in the United Kingdom.

Background: Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain.

Methods: In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants' treatment costs and scores on the EuroQol EQ-5D questionnaire. Read More

Georgian Med News 2019 Jun(291):13-19

2Shimane University, Department of General Medicine, Izumo City, Japan.

The aim of the study was the analysis of serum VEGF level in patients with varicose veins before and after the endovenous laser ablation (EVLA) and to study the role of VEGF in recurrence of the disease. The research involved 216 persons. The study group included 136 patients with varicose veins. Read More

Rozhl Chir 2019 ;98(6):248-251

Introduction: Catheter-Based Endovenous Laser Ablation (EVLA) is a commonly used alternative to surgical treatment of varicose veins. Recently, catheterization methods have proved to be methods of choice due to the preference of patients who value minimal invasiveness. Research of EVLA currently focuses on optimization of the procedure, which includes study of the benefits of the individual types of laser generators and the wavelengths used. Read More

Eur J Vasc Endovasc Surg 2019 08 21;58(2):230-242. Epub 2019 Jun 21.

Department of Dermatology, Erasmus MC, Rotterdam, the Netherlands.

Objectives: The objective of this systematic review and meta-analysis was to summarise available randomised controlled trials (RCTs) of EVLA efficacy, and to define the differences in success rate of variations in wavelength, administered energy, outcome definition, and follow up period.

Methods: A literature search was conducted in Embase, Medline (Ovid-SP), Cochrane Central Database, and Web of Science from inception to November 2017. RCTs with follow up of more than three months were included. Read More

Dtsch Med Wochenschr 2019 06 4;144(11):705-708. Epub 2019 Jun 4.

Praxis für Gefäßmedizin, Freiburg.

Endovenous Laser Ablation: Treatment with longer wavelengths and radial fibers should be used.

Radiofrequency Ablation: Results after 5 years show a very good efficacy and safety.

Further Endovenous Treatments: Data is limited. Read More

Rozhl Chir 2019 ;98(5):223-226

Varicose veins of lower extremities represent a common medical condition with minimally invasive percutaneous endovenous ablation techniques as a treatment of choice. A very rare complication is a catheter migration in the deep venous system. In the literature only 7 cases have been published so far, with only 2 cases with migration to the systemic circulation and heart involvement. Read More

Swiss Med Wkly 2019 May 2;149:w20083. Epub 2019 Jun 2.

Department of Angiology, University Hospital and University of Basel, Switzerland / Gefässpraxis am See - Lakeside Vascular Centre, Lucerne, Switzerland.

Aims Of The Study: The purpose of this study was to evaluate the safety and efficacy of endovenous laser ablation (EVLA) in patients 75 years and older in an outpatient setting.

Methods: In this multicentre retrospective study, we collected the demographic, procedural and outcome data of all consecutive patients with varicose veins class C2 to C6 undergoing EVLA of truncal and accessory saphenous veins. The primary efficacy endpoint was complete ablation of the treated veins diagnosed with duplex ultrasound at 4-week follow up. Read More

Am Fam Physician 2019 06;99(11):682-688

University of Washington Family Medicine Residency, Seattle, WA, USA.

Varicose veins are twisted, dilated veins most commonly located on the lower extremities. The exact pathophysiology is debated, but it involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure. Risk factors include family history of venous disease; female sex; older age; chronically increased intra-abdominal pressure due to obesity, pregnancy, chronic constipation, or a tumor; and prolonged standing. Read More

Br J Surg 2019 07 16;106(8):998-1004. Epub 2019 May 16.

Department of Dermatology, Erasmus Medical Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Background: The current treatment strategy for many patients with varicose veins is endovenous thermal ablation. The most common forms of this are endovenous laser ablation (EVLA) and radiofrequency ablation (RFA). However, at present there is no clear consensus on which of these treatments is superior. Read More

Vasa 2019 Aug 24;48(5):405-412. Epub 2019 Apr 24.

Ataturk University, Faculty of Medicine, Erzurum, Turkey.

Endovenous cyanoacrylate ablation is a new technique for the treatment of clinically symptomatic venous insufficiency. The results of a prospective comparative study of cyanoacrylate glue versus endovenous laser ablation for the management of incompetent great saphenous veins are presented. Patients and methods: A total of 400 subjects were treated with cyanoacrylate ablation or endovenous laser ablation between April 2014 and April 2016. Read More

Angiol Sosud Khir 2019 ;25(1):59-65

Department of Vascular Surgery, Russian Research Centre of Surgery named after Academician B.V. Petrovsky, Moscow, Russia.

The last decade has seen active development of minimally invasive (endovenous) methods of surgical removal of lower limb varicose veins (LLVV); however, the problem of increasing efficacy of these methods and improving long-term results still remains of current importance. The authors of this work propose a method of ultrasound ablation of subcutaneous veins of lower extremities. Our experimental study was aimed at determining the pattern of venous wall damage after ultrasound exposure. Read More

Braz J Med Biol Res 2019 Apr 8;52(4):e8330. Epub 2019 Apr 8.

TopMed Medical Center, Tîrgu Mureş, Romania.

We sought to assess clinical characteristics and pattern of collateral network involvement associated with development of truncal (systematized) versus diffuse/non-truncal (non-systematized) varicose veins (VVs) in patients undergoing endovascular laser photothermolysis for chronic venous insufficiency (CVI). Secondly, we aimed to assess whether the type of VVs influenced the procedural complications of endovascular laser therapy. A total of 508 patients with hydrostatic VVs of the lower limbs who underwent endovenous laser treatment were included, out of which 84. Read More

Tidsskr Nor Laegeforen 2019 Mar 6;139(5). Epub 2019 Mar 6.

Background: Use of new technology can lead to changes in the treatment course for patients and in treatment costs for the health service. The aim of this study was to compare sickness absence and time to resumption of daily activities, as well as treatment costs, for two surgical treatments for varicose veins: endovenous steam ablation and vein stripping.

Material And Method: This prospective observational study included 46 patients treated with steam ablation and 37 treated with vein stripping in the period 2015-2016. Read More

Curr Pain Headache Rep 2019 Mar 4;23(3):16. Epub 2019 Mar 4.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Purpose Of Review: Chronic venous disease (CVD), although affecting up to 40% of the US population, is often underdiagnosed by healthcare professionals due to an incomplete understanding of the presenting symptoms. CVD is a common cause of lower extremity pain and discomfort, including aching, cramping, tingling, burning, swelling, heaviness, restlessness, and fatigue, and may lead to significant morbidity if left untreated. The negative impact of CVD on quality of life is well established and the optimization of management strategies is an important area of evolving research. Read More

J Vasc Surg Venous Lymphat Disord 2019 03;7(2):234-245

Research Department, The Whiteley Clinic, Guildford, Surrey, United Kingdom; Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom. Electronic address:

Objective: The study aimed to investigate the biologic effects of the 1470-nm endovenous laser (EVL), with a jacketed fiber and a radial fiber, during EVL ablation of an ex vivo dominant extrafascial tributary of the great saphenous vein in our in vitro model by histology and immunohistochemistry.

Methods: Ten segments of the dominant extrafascial tributary of the great saphenous vein were harvested by a consultant vascular surgeon from patients during routine varicose vein surgery. Six segments were treated using an ex vivo model of our design by a 1470-nm EVL with a jacketed fiber. Read More

Ann Vasc Surg 2019 Jul 13;58:302-308. Epub 2019 Feb 13.

Vascular Surgery Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.

Background: The aim of this study is to compare 2 groups of patients treated for great saphenous vein (GSV) reflux with open surgical saphenofemoral ligation (SFL) and endovenous laser ablation (EVLA).

Methods: Consecutive patients with primary unilateral GSV reflux undergoing EVLA treatment since 2014 were enrolled, and another series of patients treated with SFL was considered. The patients were stratified according to treatment and the results were compared using the propensity score (1:1). Read More

Int Wound J 2019 Jun 15;16(3):696-702. Epub 2019 Feb 15.

Department of the Fourth Surgery, Dong-Fang Hospital of Beijing University of Chinese Medicine, Beijing, China.

To assess the efficacy and safety of endovenous laser treatment (EVLT) and high ligation (HL) for limb varicosity using meta-analysis. Multiple databases including PubMed, Springer, Excerpta Medica Database, Ovid Technologies, and China Journal Full-text database were searched for relevant studies in English or Chinese, and full-text articles were used to compare EVLT and HL for limb varicosity. Review Manager 5. Read More

Pediatr Int 2019 Apr 11;61(4):358-363. Epub 2019 Apr 11.

Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA.

Background: Klippel-Trenaunay syndrome (KTS) and related overgrowth syndromes are rare conditions that often present to academic pediatric units and multidisciplinary vascular anomaly clinics. These conditions are commonly associated with abnormalities of the superficial and deep venous structures and carry an increased risk of venous thromboembolism.

Methods: A retrospective chart review was completed of all patients treated at Johns Hopkins All Children's Hospital with endovenous laser ablation therapy (EVLT) for management of dilated embryonic veins in the setting of limb overgrowth. Read More

BMJ Open 2019 01 30;9(1):e024813. Epub 2019 Jan 30.

Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Introduction: Endovenous ablations are the new standard procedures for treatment of great saphenous vein reflux including endovenous laser ablation (EVLA), radio frequency ablation (RFA), endovenous steam ablation (EVSA), mechanochemical ablation (MOCA), cyanoacrylate injection and ultrasound-guided foam sclerotherapy (UGFS). EVLA and RFA have demonstrated similar anatomical success for short-term outcome, but results are controversial for longer term (≥5 years). Additional evidences from randomised controlled trials have been published. Read More

Phlebology 2019 Sep 9;34(8):530-535. Epub 2019 Jan 9.

2 Division of Vascular and Endovascular Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.

Angiol Sosud Khir 2018;24(4):81-87

Department of Surgery, Institute of Additional Professional Education, South Ural State Medical University of the RF Ministry of Public Health, Chelyabinsk, Russia.

The purpose of this study was to assess the incidence of the development of symptoms of damage to subcutaneous nerves after endovenous laser coagulation (EVLC) of the great saphenous vein (GSV), as well as to determine the effect of these symptoms on quality of life (QoL) of patients. Our retrospective study enrolled a total of 119 patients (mean age 50±13.9 years) subjected to 151 isolated EVLC of the GSV. Read More

J Vasc Surg Venous Lymphat Disord 2019 May 23;7(3):387-391. Epub 2018 Nov 23.

Clinic of Dermatology Luebeck Campus, University Medical Center, Schleswig-Holstein, Lübeck, Germany.

Objective: The primary objective of our study was to investigate the impact of endovenous ablation of the great saphenous vein (GSV) on the degree of tumescence of the glans penis during penile erection as well as on global erectile function (EF).

Methods: We included patients scheduled for one of three different methods of endoluminal treatment. Our questionnaire was composed of the EF domain of the International Index of Erectile Function, an additional question that has been validated for assessment of swelling (tumescence) of the glans penis, and a question on the use of erectogenic medication. Read More

Int Angiol 2019 Feb 20;38(1):22-38. Epub 2018 Nov 20.

University of Porto, Porto, Portugal.

Varicose vein surgery is among the most commonly performed surgical interventions. The standard treatment 'high ligation and stripping' has in many countries been replaced by endovenous techniques. However, there are many different techniques available. Read More

Eur J Vasc Endovasc Surg 2019 Feb 17;57(2):267-274. Epub 2018 Oct 17.

Josef Pflug Vascular Laboratory, Ealing Hospital, Middlesex, UK; Department of Surgery and Cancer, Imperial College, London, UK; West London Vascular and Interventional Centre, Northwick Park Hospital, Harrow, UK. Electronic address:

Objectives: Treatment success for chronic superficial venous insufficiency could be defined as an improvement in three domains: (i) disease specific quality of life, (ii) clinical severity, (iii) reflux. The aim was to report these at five years using a Venn diagram to profile the outcomes: a discord outcome analysis (DOA).

Methods: Patients (n = 50 patients/legs in each treated group) were randomised to endovenous laser ablation (EVLA) with concurrent phlebectomies vs. Read More

Eur J Vasc Endovasc Surg 2019 01 15;57(1):150. Epub 2018 Oct 15.

ASST Fatebenefratelli-Sacco, Vascular Surgery Unit, Milan, Italy.

J Vasc Surg Venous Lymphat Disord 2018 11;6(6):696-701

Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China.

Background: Primary iliac vein compression syndrome (IVCS) often is manifested with varicose veins (VVs), but the treatment of patients with IVCS combined with VVs remains unclear. The aim of this study was to investigate the outcome of a one-stop procedure for patients with IVCS and VVs.

Methods: The 32 enrolled patients underwent iliac stenting first and then endovenous laser ablation for VVs. Read More

J Perianesth Nurs 2019 Apr 8;34(2):368-375. Epub 2018 Oct 8.

Purpose: To investigate the effect of cold and room temperature tumescence anesthesia solution (TAS) on the treatment of lower limb varicose veins via endovenous laser ablation.

Design: On the basis of the TAS temperature, patients were divided into two groups: group A (n = 26) received room temperature (24°C) TAS, and group B (n = 25) received cold (4°C) TAS.

Methods: A numerical rating scale was used to evaluate pain. Read More

Br J Dermatol 2019 01 22;180(1):51-55. Epub 2018 Nov 22.

Department of Dermatology and, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.

Aim: Gohel et al. aimed to compare early endovenous ablation vs. deferred endovenous ablation of superficial venous reflux with regard to time to healing of venous leg ulcers, rate of healing at 24 weeks, recurrence rate, ulcer-free time and health-related quality of life. Read More

Phlebology 2019 May 18;34(4):238-245. Epub 2018 Sep 18.

The Vascular Unit, Worcestershire Royal Hospital, Worcester, UK.

Background: Thermal ablation, usually performed with tumescent local anaesthesia (TLA), is the preferred method for varicose veins treatment. Tumescent local anaesthesia is always cited; however, little detail of the procedure is presented in publications. This retrospective audit of clinical tumescent local anaesthesia practice aims to provide detailed information on an important aspect of endovenous practice. Read More

Vascular 2019 Feb 7;27(1):27-32. Epub 2018 Sep 7.

Charm Vein Center, Seoul, Republic of Korea.

Objectives: To investigate the initial outcomes of 1940 nm diode laser in the treatment of incompetent saphenous veins.

Methods: This was a prospective observational study. We treated 89 patients with 160 incompetent saphenous veins using a 1940 nm diode laser and bare fiber. Read More

Br J Surg 2018 12 22;105(13):1759-1767. Epub 2018 Aug 22.

Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK.

Background: Clinical guidelines recommend endovenous laser ablation (EVLA) over surgery based on short-term evidence, yet there are few studies reporting mid- to long-term outcomes. The aim of this study was to report the 5-year outcomes from an RCT of surgery versus EVLA for treatment of symptomatic great saphenous varicose veins.

Methods: Patients with symptomatic varicose veins due to great saphenous vein (GSV) incompetence were followed up 5 years after enrolment in a randomized trial of either surgery (saphenofemoral junction ligation, GSV strip to the knee and multiple avulsions of varicosities) or EVLA plus multiple avulsions. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Jun;43(6):651-655

Department of Radiology, Second Xiangya Hospital, Central South University, Changsha 410011, China.

Objective: To compare the effect of cold or room temperature of tumescence anesthesia solution on pain perception during and after endovenous laser ablation (EVLA) for varicose veins of lower limb.
 Methods: A total of 51 patients with lower extremity varicose vein were treated by EVLA with tumescence anesthesia solution. All patients were used for local anesthesia and randomly divided into 2 groups according to the temperature of tumescence anesthesia solution: Group A (n=26) with room temperature (24 ℃) of tumescence anesthesia solution and Group B (n=25) with cold (4 ℃) tumescence anesthesia solution. Read More

Value Health 2018 08 15;21(8):911-920. Epub 2018 Mar 15.

Academic Section of Vascular Surgery, Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; Charing Cross Hospital, London, UK.

Objectives: To analyze the cost-effectiveness of current technologies (conservative care [CONS], high-ligation surgery [HL/S], ultrasound-guided foam sclerotherapy [UGFS], endovenous laser ablation [EVLA], and radiofrequency ablation [RFA]) and emerging technologies (mechanochemical ablation [MOCA] and cyanoacrylate glue occlusion [CAE]) for treatment of varicose veins over 5 years.

Methods: A Markov decision model was constructed. Effectiveness was measured by re-intervention on the truncal vein, re-treatment of residual varicosities, and quality-adjusted life-years (QALYs) over 5 years. Read More

J Vasc Surg Venous Lymphat Disord 2018 11 29;6(6):702-706. Epub 2018 Jul 29.

Division of Vascular Surgery, Henry Ford Health System, Detroit, Mich. Electronic address:

Background: Risk factors for chronic venous disease (CVD) have been widely reported in population health management. However, predisposing factors associated with patients treated for advanced stages of CVD have yet to be established. We examined the demographics and risk factors associated with advanced clinical presentation of CVD for patients referred for vein ablation. Read More

Eur J Vasc Endovasc Surg 2018 Oct 2;56(4):553-560. Epub 2018 Jul 2.

Department of Cardiovascular Surgery, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

Objective: To compare early and two year results for N-butyl cyanoacrylate (NBCA), radiofrequency ablation (RFA), and endovenous laser ablation (EVLA) in the treatment of varicose veins.

Methods: This was a randomised clinical trial. Five hundred and twenty five patients were blindly randomised into NBCA, RFA, and EVLT groups (175 patients to each group; block randomisation using sealed envelopes). Read More