Ablación endovascular por radiofrecuencia. Efecto sobre el diámetro venoso con el uso del catéter ClosureFast®

Moreno, Hernán Bauzá; Dotta, Mariana; Katsini, Roxana; Fosser, Carolina Marquez; Rochet, Sofía; Pared, Carlos; Martínez, Hugo Alejandro Alvarado

doi:10.1016/j.ciresp.2016.02.008

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…La tasa de éxito del procedimiento es cercana al 100%, similar a lo descrito en otros estudios en los que se realizaron termoablaciones con radiofrecuencia de las venas safenas. Tanto la tasa de ingresos como la de visitas a urgencias son menores del 3%, en rangos similares a los descritos en otros estudios 6,7 .…”

Section: Discussionunclassified

Cirugía ambulatoria de la insuficiencia venosa crónica mediante termoablación por radiofrecuencia: calidad y satisfacción

Jiménez-Román,

Salazar-Álvarez,

Riera-del Moral

2023

CIRU

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Antecedentes: La enfermedad venosa crónica es una patología frecuente y prevalente. Su tratamiento quirúrgico ha mostrado ser coste-efectivo. La endoablación térmica realizada como cirugía mayor ambulatoria (CMA) es la técnica de elección. Objetivo: Conocer la satisfacción de los pacientes tras CMA y la calidad de la atención brindada. Método: Estudio observacional, descriptivo y transversal, realizado entre enero de 2019 y marzo de 2020. Se realizó una encuesta a los pacientes intervenidos mediante termoablación endovascular por radiofrecuencia en dos hospitales de España, con dos cuestionarios: uno ad hoc y otro de satisfacción (SERCAL). Se midieron índices de calidad para CMA. Resultados: Analizamos 156 episodios. Se realizaron 145 intervenciones. Encontramos 4 (2.8%) ingresos no programados. Tres pacientes (2.1%) acudieron a urgencias. Hubo una tasa de éxito del 99.3%. El 100% de los pacientes contaban con recomendaciones prequirúrgicas y consentimiento informado. Obtuvimos 48 encuestas (índice de respuesta: 33.1%). Todos los pacientes otorgaron una calificación ≥ 8 en calidad de atención (x = 9.83) y recomendarían este procedimiento a sus familiares (x = 9.71). Conclusiones: La termoablación endovascular por radiofrecuencia realizada en CMA tiene una alta tasa de éxito y unas tasas de ingreso y visita a urgencias muy bajas. La satisfacción de los pacientes es elevada.Palabras clave: Insuficiencia venosa. Ablación por radiofrecuencia. Procedimientos quirúrgicos ambulatorios. Vena safena. Calidad de cuidado de la salud. Satisfacción del paciente.

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Section: Discussionunclassified

Cirugía ambulatoria de la insuficiencia venosa crónica mediante termoablación por radiofrecuencia: calidad y satisfacción

Jiménez-Román,

Salazar-Álvarez,

Riera-del Moral

2023

CIRU

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Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy

Ielpo

Pueyo-Périz

Radosevic

et al. 2021

International Journal of Hyperthermia

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Purpose: Multiple attempts have been made to manage the pancreatic stump and the pancreatic duct in order to reduce the rate of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD), however radiofrequency-based technologies could help to achieve this goal. Previous encouraging clinical and experimental results support the use of endoluminal thermal ablation (ETHA) of the main pancreatic duct to reduce pancreatic exocrine secretion and hence POPF. We here describe our initial clinical experience with ETHA of the main pancreatic duct in two cases at high risk of POPF. Methods: Two cases underwent PD for malignancy with a high risk of POPF (adenocarcinoma, obese patients, surgical difficulties with heavy intraoperative blood loss, soft pancreas or walled-off pancreatitis and a tight small pancreatic main duct). In both cases, ETHA of the main pancreatic duct was conducted intraoperatively just before Blumgart-type pancreatic-jejunal anastomosis using a ClosureFast catheter (Medtronic, Mansfield, MA, USA) normally used for varicose vein treatment (therefore an offlabel use). Results: Although a clear radiological POPF was detected in the second case, the clinical postoperative course in both cases was uneventful. Little pancreatic fluid collected in the abdominal drainage with low levels of amylase enzyme, confirming low exocrine pancreatic function. No other procedurerelated complications were detected. Conclusion: Endoluminal thermal ablation of the main pancreatic duct may be a feasible and safe technique to reduce the adverse effects of POPF after PD.

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A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

et al. 2021

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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. The methodologic quality of the articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). A random-effects model was used to estimate anatomic success, defined as AASV occlusion. The secondary outcomes were pain during and after treatment, venous clinical severity score, quality of life, esthetic result, time to return to daily activities, and complications. Results The search identified 860 articles, of which 16 met the inclusion criteria. A total of 609 AASVs were reported. The included studies were of poor or moderate quality according to MINORS score. The pooled anatomic success rates were 91.8% after endovenous laser ablation and radiofrequency ablation (EVLA, RFA, 11 studies), 93.6% after cyanoacrylate closure (3 studies), and 79.8% after sclerotherapy (2 studies). The non-pooled anatomic success rate was 97.9% after phlebectomy and 82% after CHIVA. Paresthesia was seen after EVLA in 0.7% of patients (6 studies). Phlebitis was seen in 2.6% of patients after RFA (2 studies), 27% after sclerotherapy (1 study), and 12% after the phlebectomy (1 study). Deep venous thrombosis and skin burn did not occur. Conclusion Treatment of AASV incompetence is safe and effective. Despite limited evidence, occlusion of the AASV can be achieved with endovenous thermal ablation and cyanoacrylate. There does not appear to be a benefit of EVLA compared to RFA regarding treatment efficacy. Phlebectomy shows promising results if the saphenofemoral junction is competent. Lower results are seen after sclerotherapy and CHIVA. However, studies with sufficient sample sizes of solely treatment of AASV incompetence are needed to draw firm conclusions.

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Ablación endovascular por radiofrecuencia. Efecto sobre el diámetro venoso con el uso del catéter ClosureFast®

Cited by 5 publications

References 13 publications

Cirugía ambulatoria de la insuficiencia venosa crónica mediante termoablación por radiofrecuencia: calidad y satisfacción

Cirugía ambulatoria de la insuficiencia venosa crónica mediante termoablación por radiofrecuencia: calidad y satisfacción

Clinical case report: endoluminal thermal ablation of main pancreatic duct for patients at high risk of postoperative pancreatic fistula after pancreaticoduodenectomy

A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

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