Comparative analysis of endovenous laser ablation versus ultrasound‐guided foam sclerotherapy for the treatment of venous leg ulcers

Weber, Benedikt; Marquart, Elias; Deinsberger, Julia; Tzaneva, Stanislava; Böhler, Kornelia

doi:10.1111/dth.15322

Cited by 11 publications

(5 citation statements)

References 51 publications

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“…In comparison to foam sclerotherapy, numerous studies showed that foam sclerotherapy has a higher recurrence rate compared to EVLA, [15][16][17] so in our case, foam sclerotherapy is not an option that we would choose.…”

Section: Discussionmentioning

confidence: 69%

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Taofan,

Dakota,

Kartamihardja

et al. 2024

F1000Res

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Background Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients’ health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been associated with reducing ulcer recurrence levels and promoting faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches. Case illustration Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication. Conclusion We’ve reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK where there is still significant reflux is safe and provides satisfactory results in patients with VLU.

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Section: Discussionmentioning

confidence: 69%

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Taofan,

Dakota,

Kartamihardja

et al. 2024

F1000Res

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“…Another study compared the efficacy of endovenous laser ablation and UGFS for the treatment of VLUs. Rates of ulcer resolution and ulcer healing time after endovenous intervention were comparable between both treatment modalities 13 . Nevertheless, a significantly higher relapse rate was observed in UGFS‐treated patients.…”

Section: Discussionmentioning

confidence: 77%

“…Rates of ulcer resolution and ulcer healing time after endovenous intervention were comparable between both treatment modalities. 13 Nevertheless, a significantly higher relapse rate was observed in UGFS‐treated patients. Therefore, the optimal method for endovenous ablation remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Early versus deferred endovenous sclerotherapy of superficial venous reflux in patients with venous ulceration

Liu,

Guo

2023

International Wound Journal

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This study aimed to compare early endovenous sclerotherapy with superficial venous reflux combined with compression therapy and deferred intervention in patients with venous leg ulcers (VLUs). A total of 80 patients with 80 VLUs treated at the Department of General Surgery, Shangjin Nanfu Hospital, Chengdu, China, between February 2022 and January 2023 were included in the study. The primary outcome was the time to ulcer healing from the date of compression therapy or endovenous sclerotherapy. Secondary outcome measures were the rate of ulcer healing at 6 months, the rate of ulcer recurrence at 6 months, and patient‐reported health‐related quality of life. A total of 54 patients received early intervention and 26 received deferred intervention. The patient and clinical characteristics at baseline were similar between the two treatment groups. The median time to ulcer healing was 1.5 months (95% confidence interval [CI], 1.3–1.7 months) in the early‐intervention group and 3.5 months (95% CI, 2.9–4.1 months) in the deferred‐intervention group. The time to ulcer healing was shorter in the early‐intervention group than in the deferred‐intervention group (p < 0.001). The rate of ulcer healing at 6 months was 94% in the early‐intervention group and 92% in the deferred‐intervention group. The rate of ulcer recurrence before the end of the 6‐month follow‐up period was 2% in the early‐intervention group and 4% in the deferred‐intervention group. In conclusion, early endovenous sclerotherapy for superficial venous reflux resulted in faster healing of VLUs than deferred endovenous sclerotherapy.

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“…The treatment of underlying venous reflux can be achieved through various minimally invasive procedures such as FS and endovenous laser (EVLA) and radiofrequency (RFA) ablation or mechanochemical ablation (MOCA); the latter has been reported as a safe and effective technique in treating chronic venous ulcers, appearing to provide comparable results to techniques relying on thermal ablation. 7 Likewise, Weber et al 8 reported in a small study similar rates of venous ulcer resolution and healing time after EVLA and FS but with significantly higher relapse rate in FS-treated patients.…”

Section: Discussionmentioning

confidence: 93%

Sheath-Based Combined Foam Sclerotherapy to Promote Management of Extensive Insufficiency of the Great Saphenous Vein in Venous Ulcers

Georgakarakos

Dimitriadis

2023

Vasc Endovascular Surg

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Background: Foam sclerotherapy is considered an acceptable method to treat great saphenous vein (GSV) insufficiency, promoting occlusion of its trunk and eradicating reflux. Various modalities and techniques have been described, varying form foam infusion through multiple short cannulae along the GSV to catheter-directed techniques in order to facilitate complete proximal GSV occlusion and improve technical and clinical success. Purpose: To present a modification of the sclerotherapy tehcnique where the presence of venous ulcers poses an extra challenge to the treatment of GSV treatment. Technique: We describe a technical proposal of single foam perfusion through a 11 cm 5F sheath placed at the knee level combined with simultaneous retrograde infusion below the knee. Perivenous tumescent segmental infiltration with cold normal saline at 4°C is applied initially to reduce the diameter in those GSV >6-7 mm. Conclusions: This combination avoids multiple vein cannulation in the GSV along the thigh as well as the need for antegrade infusion when GSV cannulation at the lower tibia is prohibited by a large ulcer area.

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Comparative analysis of endovenous laser ablation versus ultrasound‐guided foam sclerotherapy for the treatment of venous leg ulcers

Cited by 11 publications

References 51 publications

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Early versus deferred endovenous sclerotherapy of superficial venous reflux in patients with venous ulceration

Sheath-Based Combined Foam Sclerotherapy to Promote Management of Extensive Insufficiency of the Great Saphenous Vein in Venous Ulcers

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