Endovenous Laser Ablation and Concomitant Foam Sclerotherapy: Experience in 504 Patients

Yılmaz, Saim; Çeken, Kağan; Alparslan, Ahmet Şükrü; Durmaz, Mehmet Sedat; Sindel, Timur

doi:10.1007/s00270-011-0329-1

Cited by 17 publications

(13 citation statements)

References 13 publications

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“…This finding is also consistent with the literature. [16] Nonetheless, there are some limitations to this study. Our short follow-up is the main limitations which precludes long-term evaluation.…”

Section: Discussionmentioning

confidence: 92%

“…[14,15] None of patients needed a repeat surgery, and less than 3% needed sclerotherapy at five years during follow-up in a randomized-controlled trial (RCT) comparing combination therapy for VVs in the form of highligation (HL) combined with either endovenous laser ablation (ELA) or stripping (S). [16] Concomitant phlebotomy with ELA has been shown to decrease the need for secondary procedures by 62%, compared to ELA alone, according to studies. [17,18] Although the current evidence suggests lower recurrence rates and less need for repeated treatments in combination therapy, the practice in different centers still varies with no uniform agreement on combination therapy.…”

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confidence: 99%

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Concomitant therapies for varicose veins: Our high-volume, single-center experiences in the UK

Elshiekh¹

2020

Turk J Vasc Surg

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Objectives: This study aims to assess the feasibility of combined truncal endothermal ablation (ETA) and ultrasound-guided foam sclerotherapy (UGFS) in a single treatment session and compare this technique to published re-intervention rates following truncal ablation alone. Patients and methods: The study was a retrospective data analysis of prospectively collected data. The patients had a preoperative US and then Endothermal Ablation (ETA) with concomitant UGFS. The need for a secondary treatment, technical success, operation time, patient satisfaction, complications, and recurrence were evaluated. Results: The mean follow-up was 4.4±3.7 months. The technical success was achieved in all patients. Sixty-six (93%) of the patients did not need further treatments. Five patients (7%) needed further interventions with repeated combined ETA and UGFS (n=1, 1.4%) and sclerotherapy (n=4, 5.6%). These interventions did not increase the financial cost of treatment, compared to ETA alone. Conclusion: Our study results suggest that one-stop dual therapy for the treatment of VV is associated with less need for further treatment, compared to truncal ETA alone without increasing the treatment cost.

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Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

Concomitant therapies for varicose veins: Our high-volume, single-center experiences in the UK

Elshiekh¹

2020

Turk J Vasc Surg

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“…After full text evaluation, 62 studies discussing sclerotherapy management of varicose veins were included involving 3689 patients (CDFS 789 and FS 2900). 11,16,19,20,28–84 Of these, there were 48 studies for UGFS and 15 studies for CDFS. There was only one randomized controlled trial directly comparing these two alternatives.…”

Section: Resultsmentioning

confidence: 99%

Catheter-directed foam sclerotherapy, an alternative to ultrasound-guided foam sclerotherapy for varicose vein treatment: A systematic review and meta-analysis

et al. 2020

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Purpose Catheter-directed foam sclerotherapy is a new addition to the treatment modalities available for varicose veins. As a modification of ultrasound-guided foam sclerotherapy, catheter-directed foam sclerotherapy has been purported to offer higher complete ablation rates and an improved safety profile. The aim of this study is to appraise the current literature on the outcomes of catheter-directed foam sclerotherapy compared to ultrasound-guided foam sclerotherapy in chronic venous insufficiency. Methods The review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data from studies that reported the outcomes of catheter-directed foam sclerotherapy and ultrasound-guided foam sclerotherapy were extracted, to determine the pooled proportion of complete ablation rates, using a random effect meta-analysis model. Results A total of 62 studies, involving 3689 patients, were included in the systematic review. Higher rates of complete ablation were reported in catheter-directed foam sclerotherapy compared to ultrasound-guided foam sclerotherapy during the short- and medium-term follow-ups (Relative Risk = 1.06, Relative Risk = 1.15, Relative Risk = 1.19, p < 0.05). Fewer major and minor complications were also reported in patients who underwent catheter-directed foam sclerotherapy (Relative Risk = 0.23, Relative Risk= 0.43–0.76, p < 0.05). Conclusion Catheter-directed foam sclerotherapy has been demonstrated to have many advantages over ultrasound-guided foam sclerotherapy, offering superior complete ablation rates in the short-, medium- and long-term follow-ups. It also has a better safety profile, conferring a lower risk of major and minor complications. The conclusions should however be viewed in the context of significant limitations imposed by limited study data.

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“…According to the extent of the lesion and for better treatment effects, combined treatment modalities have been constantly appearing 22 . Combined treatments, such as EVLA-FS 23,24 , HL-FS 25 , and HL-EVLA 26 , have been introduced successively. Comprehensive treatments can draw on their respective strengths to achieve the best effect, especially when treating severe or recurrent VVs 24,25,27 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of combined compression and surgery with high ligation-endovenous laser ablation-foam sclerotherapy with compression alone for active venous leg ulcers

Liu

Zheng

et al. 2019

Sci Rep

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We aimed to assess the ulcer healing time and recurrence rates after treatment with compression therapy (CT) with or without high ligation-endovenous laser ablation-foam sclerotherapy (HL-EVLA-FS) in people with active venous leg ulcers (VLUs). A retrospective cohort study was conducted with 350 patients with active VLUs treated by compression with or without HL-EVLA-FS in our hospital from 2013 to 2017. The primary outcome was the ulcer healing time; secondary outcomes were the 12-month recurrence rates, the relationship between recurrence and venous reflux, and the complications of the two treatments. In total, 193 patients (200 limbs) underwent compression plus HL-EVLA-FS, and 157 patients (177 limbs) underwent CT alone. The ulcer healing time was shorter in the compression plus HL-EVLA-FS group than in the CT alone group (Hazard Ratio [HR] for ulcer healing, 1.845 [95% CI, 1.474–2.309], P = 0.0001). The 12-month ulcer recurrence rates were significantly reduced in the compression plus HL-EVLA-FS group (HR for ulcer recurrence, 0.418 [95% CI, 0.258–0.677], P = 0.0001). Calf perforator vein reflux (CPVR) and isolated superficial venous reflux (ISVR) were risk factors for ulcer recurrence. The combined operation with CT resulted in faster healing of VLUs, a lower ulcer recurrence rate and lower VCSS values after intervention than CT alone.

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Endovenous Laser Ablation and Concomitant Foam Sclerotherapy: Experience in 504 Patients

Abstract: ELA and concomitant foam sclerotherapy is feasible and effective. The procedures are associated with a low complication rate and can be performed in both legs in the same session. Concomitant use of laser and foam may potentially decrease the recanalization rate of laser-ablated vessels.

Cited by 17 publications

References 13 publications

Concomitant therapies for varicose veins: Our high-volume, single-center experiences in the UK

Concomitant therapies for varicose veins: Our high-volume, single-center experiences in the UK

Catheter-directed foam sclerotherapy, an alternative to ultrasound-guided foam sclerotherapy for varicose vein treatment: A systematic review and meta-analysis

Comparison of combined compression and surgery with high ligation-endovenous laser ablation-foam sclerotherapy with compression alone for active venous leg ulcers

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