Does Endovenous Laser Ablation Induce Endothelial Damage at the Saphenofemoral Junction?

Heere-Ress, Elisabeth; Veensalu, Marge; Wacheck, Volker; Tzaneva, Stanislava; Kittler, Harald; Kapiotis, Stylianos; Wolzt, Michael; Böhler, Kornelia

doi:10.1111/j.1524-4725.2011.02106.x

Cited by 5 publications

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“…7 Both shrinkage and thrombosis account for the initial vascular closure, after which the wound is remodeled and replaced by fibrotic tissue to permanently 'seal the deal.' 10 Although the incidence of ELT-induced thrombosis has been proven by duplex ultrasound, 11 increased levels of circulating fibrin degradation products following ELT, 7,12 histology, 13 and the documented effects of anticoagulants, 11 the exact role of thrombosis in vascular obliteration remains elusive. The contribution of thrombosis to vascular closure could be disputed on the basis of the finding that recanalization, which evidently occurs only in thrombostatic veins and not fully constricted or fibrotic veins, does not negatively affect ELT outcome.…”

Section: Sirmentioning

confidence: 99%

“…7,12,46 It is therefore unfortunate that in all papers on the histological features of ELT-subjected veins, only hematoxylin & eosin staining was employed and not one of the abovementioned stains. The use of these stains would decisively prove the manifestation of secondary hemostasis following ELT and provide detailed information on thrombus organization kinetics (e.g., fibrin replacement by collagen 47 ) when analyzed as a function of time after ELT.…”

Section: Sirmentioning

confidence: 99%

“…On a final note, several specific methods are available to assess fibrin formation, including histochemical stains such as Picro-Mallory, Martius-Scarlett-Blue, Fuchsin-Miller, and Carstair's, [42][43][44][45] immunohistochemical stains using labeled anti-fibrin antibodies, 45 or biochemical/enzymatic assays in case of biological fluids. 7,12,46 It is therefore unfortunate that in all papers on the histological features of ELT-subjected veins, only hematoxylin & eosin staining was employed and not one of the abovementioned stains. The use of these stains would decisively prove the manifestation of secondary hemostasis following ELT and provide detailed information on thrombus organization kinetics (e.g., fibrin replacement by collagen 47 ) when analyzed as a function of time after ELT.…”

Section: Sirmentioning

confidence: 99%

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Thrombosis versus thermal coagulum formation as a result of endovenous laser treatment: Biochemistry versus photophysics

Heger

2013

Phlebology

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Section: Sirmentioning

confidence: 99%

Section: Sirmentioning

confidence: 99%

Section: Sirmentioning

confidence: 99%

See 1 more Smart Citation

Thrombosis versus thermal coagulum formation as a result of endovenous laser treatment: Biochemistry versus photophysics

Heger

2013

Phlebology

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“…Pouco se sabe sobre a ação ou ativação das técnicas termoablativas na cascata de coagulação ou em outros fatores moleculares pró-trombóticos (LURIE; KISTNER, 2013;HEERE-RESS et al, 2011). A busca por biomarcadores que permitam a identificação de predisposições ou melhora nas técnicas diagnósticas do TEV atualmente é o objetivo de inúmeras pesquisas em especial no campo da oncologia.…”

Section: Potenciais Marcadores Séricos De Risco Tromboembólicounclassified

“…Autores já estudaram fatores de risco clínicos e anatômicos para EHIT e entre eles estão a técnica cirúrgica, o diâmetro da veia, idade e flebectomias concomitantes (SUFIAN et al, 2015). Porém, poucos avaliaram alterações inflamatórias, prótrombóticas, moleculares plasmáticas ou teciduais desses pacientes (LURIE; KISTNER, 2013;HEERE-RESS et al, 2011) e menos ainda compararam adequadamente essas técnicas com a técnica cirúrgica padrão.…”

Section: -Discussãounclassified

Avaliação de marcadores séricos de inflamação, trombose e moléculas de adesão no tratamento da insuficiência da veia safena magna pelas técnicas cirúrgica convencional e termoablação por radiofrequência

Schreiner¹

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Introduction: the standard surgical treatment for incompetent saphenous veins is surgical ligation and removal of the affected vein. The endovenous thermal ablation is one of the recent endovenous treatments to great saphenous reflux with grade IA of recommendation. Endovenous thermal ablation is a minimally invasive technique that causes endothelial damage and local inflammation obliterating the target vein. Some studies on the risk factors for the occurrence of thrombosis in varicose vein surgery have already been carried out, but data are still scarce on the actual role of serum markers of hypercoagulability. Objective: To investigate serum markers of inflammation, thrombosis and adhesion molecules in treating great saphenous vein insufficiency by conventional surgical techniques and radiofrequency thermal ablation. Materials and methods: We selected 35 patients with varicose veins in the lower limbs with the indication for surgical treatment of the great saphenous vein. The patients were divided into two groups, one group undergoing radiofrequency endovenous thermal ablation of the great saphenous vein and the other group undergoing conventional surgery. All patients underwent duplex ultrasonography within seven days, within one month. Blood samples were collected before the procedure, at seven days and 30 days after the procedure. Evaluation of the levels of inflammatory mediators such as ICAM, VCAM, von Willebrand factor, soluble Pselectin, endogenous thrombin potential was investigated in comparisons between the conventional approach and radiofrequency. Results: The mean age of participants was 50 ± 12 years, with 27 (77.1%) patients being female. The mean Body Mass Index (BMI) was 28 ± 6 kg/m² with no statistical difference between the groups. The most frequent comorbidity was systemic arterial hypertension; 11 (31.4%) patients with homogeneous distribution, three patients (12.5%) had class II EHIT. In the assessment of systemic inflammatory activity, WBC and platelet count, there were no significant differences between the groups at any of the times. Again, there was no significant difference in the assessment of thrombin generation and endothelial adhesion molecules, either in the intragroup or in the intergroup assessment. Conclusion: in the postoperative period, there is no difference in activation in the generation of thrombin generation, endothelial injury or activation of adhesion molecules between radiofrequency thermal ablation and stripping of the great saphenous vein.

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Endovascular laser–tissue interactions and biological responses in relation to endovenous laser therapy

et al. 2013

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Endovenous laser treatment (ELT) has evolved into a frequently employed modality for the treatment of leg varicose veins. Due to the very high complete response rates, minimal complications and side effects, and the possibility to monitor therapeutic outcome noninvasively by duplex ultrasound, a considerable amount of reports have been published on clinical and translational studies, whereas disproportionally few studies have been performed to elucidate the molecular and cellular basis for post-ELT vessel obliteration. Consequently, this review addresses the putative molecular and cellular mechanisms responsible for varicose vein obliteration following laser irradiation in the context of endovenous laser–tissue interactions. First, the histological profile of laser-treated varicose veins is summarized, and an account is given of the temporal and spatial dynamics of cells involved in inflammation and remodeling in the heat-affected vein segment. Inasmuch as thrombotic occlusion of the venous lumen blocks circulatory access to the affected vessel segment and thermal damage in the vascular wall causes most cells to die, the majority of cells involved in inflammation and remodeling have to be recruited. Second, the (possible) biochemical triggers for the chemotactic attraction of immune cells and fibroblasts are identified, comprising (1) thermal coagula, (2) thrombi, (3) dead and dying cells in the vein wall, and (4) thermally denatured extracellular matrix proteins in the vein wall. The molecular biology underlying the chemotactic signaling and subsequent obliterative remodeling is elucidated. Finally, the relative contribution of every biochemical trigger to obliterative remodeling is addressed.

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Does Endovenous Laser Ablation Induce Endothelial Damage at the Saphenofemoral Junction?

Cited by 5 publications

References 38 publications

Thrombosis versus thermal coagulum formation as a result of endovenous laser treatment: Biochemistry versus photophysics

Thrombosis versus thermal coagulum formation as a result of endovenous laser treatment: Biochemistry versus photophysics

Avaliação de marcadores séricos de inflamação, trombose e moléculas de adesão no tratamento da insuficiência da veia safena magna pelas técnicas cirúrgica convencional e termoablação por radiofrequência

Endovascular laser–tissue interactions and biological responses in relation to endovenous laser therapy

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