Endovenous ablation therapy (laser or radiofrequency) or foam sclerotherapy versus conventional surgical repair for short saphenous varicose veins

Paravastu, Sharath; Horne, Margaret; Dodd, P.D.F.

doi:10.1002/14651858.cd010878.pub2

Cited by 75 publications

(52 citation statements)

References 40 publications

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“…In light of the anatomical differences between the great and small saphenous veins, some researchers suggest that a DVT rate is higher in patients treated invasively for SSV incompetence. Paravastu et al analysed the results of endovenous ablation of the small saphenous vein in a Cochrane analysis from 2016 [32]. According to the analysis of three RCTs comparing laser ablation with surgery and one comparing ultrasound-guided foam sclerotherapy (UGFS) with surgery, the rate of DVT was 0.6% after endovenous laser treatment and 1% in the group treated with surgery [32].…”

Section: Deep Vein Thrombosis and Venous Thromboembolism Incidence Inmentioning

confidence: 99%

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

Wołkowski¹,

Urbanek²

2018

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Deep vein thrombosis (DVT) remains one of the most important clinical complications of varicose vein surgery. Despite the fact that procedures employed in the treatment of varicose veins are commonly classified as carrying a low risk of thromboembolism, this risk may vary significantly across different patients due to the presence of individual risk factors. This is a review of the risk of DVT in surgical and minimally invasive treatment of varicose veins. In retrospective studies addressing open varicose vein surgery, the rate of symptomatic DVT has been estimated at approximately 1%, but in prospective imaging-based studies, the risk of DVT in clinical settings seems to be much higher. The role of risk factors for DVT as well as their proper evaluation and individual risk stratification are significant. Because of population aging, a higher incidence of thromboembolic complications can be expected, suggesting the need for an individualised approach to risk stratification and appropriate risk-adjusted prophylaxis in patients who are candidates for varicose vein treatment. The implementation of new treatment modalities, in particular thermal and non-thermal ablation, does not eliminate the risk of DVT completely despite their relatively minimally invasive nature. Moreover, these methods can be related to the occurrence of new types of thrombotic complications, such as endovenous heat-induced thrombosis. The limited number of prospective studies regarding thromboembolism prophylaxis in modern phlebological treatment warrants further research on the importance of patient assessment and evaluation of procedure-related risk factors for venous thromboembolism.

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Section: Deep Vein Thrombosis and Venous Thromboembolism Incidence Inmentioning

confidence: 99%

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

Wołkowski¹,

Urbanek²

2018

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“…The issue of recurrence is also a problem after foam treatment and no long term results are available for adequate comparison with other techniques. 31,32 These data suggest that there is no conclusion concerning which is the best method to avoid recurrence. There is one RCT investigating the CHIVA technique with 10 years' follow-up in which it was associated with less recurrence than the stripping technique, making it a good option for treating patients with saphenous vein insufficiency.…”

Section: Recurrence Of Varicose Veinsmentioning

confidence: 99%

CHIVA to Treat Saphenous Vein Insufficiency in Chronic Venous Disease: Characteristics and Results

Faccini¹,

Ermini²,

Franceschi³

2020

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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There is considerable debate in the literature with relation to the best method to treat patients with chronic venous disease (CVD). CHIVA is an office-based treatment for varicose veins performed under local anesthesia. The aim of the technique is to lower transmural pressure in the superficial venous system and avoid destruction of veins. Recurrence of varicosities, nerve damage, bruising and suboptimal aesthetic results are common to all treatments for the disease. This paper evaluates and discusses the characteristics and results of the CHIVA technique. We conclude that CHIVA is a viable alternative to common procedures that is associated with less bruising, nerve damage, and recurrence than stripping saphenectomy. The main advantages are preservation of the saphenous vein, local anesthesia, low recurrence rates, low cost, low pain, and no nerve damage. The major disadvantages are the learning curve and the need to train the team in venous hemodynamics.

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“…However, anatomical and clinical recurrence rates in a RCT meta-analysis of endovenous (UGFS, EVLA, and radiofrequency ablation [RFA]) versus surgical GSV treatments revealed a lack of definite superiority or inferiority of a specific treatment option [13]. Systematic review comparing surgery, endothermal techniques and UGFS in the treatment of small saphenous vein (SSV) incompetence demonstrated superiority of endovenous thermal ablation over surgery and UGFS in terms of anatomical success in one meta-analysis, whereas in another study inconclusive results with respect to the anatomical effectiveness of UGFS were noted [14,15]. Carrol et al stressed that their results were inconclusive regarding which intervention was the most effective with clinical severity score being most favourable in UGFS, and RFA being the most beneficial treatment when comparing pain scores [10].…”

Section: Ultrasound-guided Foam Sclerotherapyan Overviewmentioning

confidence: 99%

Evidence of Foam Sclerotherapy in the Treatment of Recurrent Varicose Veins

Peter¹,

Pourhassan²

2019

Phlebologie

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Purpose Efficacy and safety of ultrasound-guided foam sclerotherapy (UGFS) for the treatment of primary venous disease is proven, but the main application field of UGFS remains the treatment of recurrent varicose veins (RVV). The aim of this study is to determine the extent to which this treatment indication is evidence-based. Methods In PubMed and other publicly accessible databases, literature was reviewed until June 2018 and checked for relevance. The focus was on results with regard to anatomical success as well as clinical success and perception by patients. Results Several observational studies comprised a subgroup of RVV patients, but systematic stratification for RVV patients were only rarely performed. In most of these studies including the few reports specifically investigating RVV patients anatomical success as the primary outcome measure revealed similar results compared to primary interventions and favourable results in patients with neovascularization. Data on clinical outcome and patient perception were inconclusive due to low study numbers and insufficient stratification. Complications in RVV patients were rare. Conclusion Although the advantages inherent to the UGFS principle provide a strong rationale that this method best meets the requirements of the specific RVV characteristics, concept and previous observations should be supported by more evidence. Systematic studies in RVV patients with sufficient sample size are required.

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Endovenous ablation therapy (laser or radiofrequency) or foam sclerotherapy versus conventional surgical repair for short saphenous varicose veins

Cited by 75 publications

References 40 publications

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

A review of the risk of deep vein thrombosis in surgical and minimally invasive treatment of varicose veins

CHIVA to Treat Saphenous Vein Insufficiency in Chronic Venous Disease: Characteristics and Results

Evidence of Foam Sclerotherapy in the Treatment of Recurrent Varicose Veins

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