Endovenous Laser Ablation of the Great Saphenous Vein with Large Sapheno-Femoral Junction

Фокин, А. А.; Борсук, Д. А.

doi:10.17116/flebo201812135-39

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…3,11,15 Three studies reported on EHIT occurrence with crude and pooled outcomes of 1.7% (8/465) and 1.6% (95% CI: 0.3–3.5) ( I 2 = 0%, p = 0.72). 14,16,17 Out of the three included studies, two provided further information regarding EHIT classification with one recorded EHIT III and three EHIT II incidents.…”

Section: Resultsmentioning

confidence: 99%

“…The crude and pooled technical success estimates were 99.5% (630/633) and 99.9% (95% CI: 98.9–100.0) ( I 2 = 55%, p = 0.15). 11,13,14,16,17 Three studies reported on DVT occurrence. The crude and pooled DVT estimates were 0.3% (1/368) and 0.04% (95% CI: 0.0–3.4) ( I 2 = 25%, p = 0.26).…”

Section: Resultsmentioning

confidence: 99%

“…21 However, in two studies, the recorded mean GSV diameter exceeded 20 mm. 14,15 Although these studies showcased favorable treatment outcomes, it is essential to exercise caution when drawing indirect inferences about the management of GSV aneurysms based solely on such minimal information. Given the need for a comprehensive understanding and guidance in the field of GSV aneurysmal disease, further research is paramount.…”

Section: Discussionmentioning

confidence: 99%

“…Seven studies, four comparative case series, and three noncomparative case series comprised of 2552 patients, and 2564 GSV were finally included. Three studies described interventions for GSV of diameters exceeding 12 mm, and four studies depicted interventions for GSV larger than 13 mm [11][12][13][14][15][16][17] (Table 1).…”

Section: Baseline Study Characteristicsmentioning

confidence: 99%

“…Seven studies, four reporting on RFA and three on EVLA ablation, were included in the GSV occlusion endpoint. The crude and pooled GSV occlusion estimates by the end of follow-up were 95.4% (794/832) and 95.9% (95% CI: 93.6-97.8) (I 2 = 22%, p = 0.26) [11][12][13][14][15][16][17] (Figure 1).…”

Section: Overall Endovenous Thermal Ablation Efficacy and Safetymentioning

confidence: 99%

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Endovenous thermal ablation in the treatment of large great saphenous veins of diameters > 12 mm: A systematic review meta-analysis and meta-regression

Bontinis

Koutsoumpelis

et al. 2023

Vasc Med

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Background: We sought to assess the safety and efficacy of endovenous thermal ablation (EVTA) in treating large great saphenous veins (GSV) > 12 mm in diameter. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 for comparative and noncomparative studies depicting EVTA in the treatment of GSV > 12 mm. Primary endpoints included GSV occlusion, technical success, deep vein thrombosis (DVT), and endovenous heat-induced thrombosis (EHIT). We conducted a comparative analysis between GSV > 12 mm and < 12 mm and a meta-regression analysis for two sets of studies, one including the whole dataset, containing treatment arms of comparative studies with GSV < 12 mm and one exclusively for GSV > 12 mm. Results: Seven studies, including 2564 GSV, depicting radiofrequency (RFA) and endovenous laser ablation (EVLA) were included. GSV > 12 mm occlusion, technical success, DVT, and EHIT estimates were 95.9% (95% CI: 93.6–97.8), 99.9% (95% CI: 98.9–100.0), 0.04% (95% CI: 0.0–3.4), and 1.6% (95% CI: 0.3–3.5). Meta-regression revealed a negative association between GSV diameter and occlusion for both the whole dataset ( p < 0.01) and the > 12 mm groups ( p = 0.04), GSV diameter and technical success for both groups ( p < 0.01), ( p = 0.016), and GSV diameter and EHIT only for the whole dataset ( p = 0.02). The comparative analysis between GSV < 12 mm and GSV > 12 mm displayed an occlusion estimate of OR 1.79 (95% CI: 1.25–2.56) favoring small GSV. Conclusion: Whereas we have displayed excellent occlusion and technical success results for the EVTA of GSV > 12 mm, our analysis has illustrated the unfavorable impact of GSV diameter on occlusion, technical success, and EHIT outcomes regardless of the 12 mm threshold. Potential parameter or device adjustments in a diameter-oriented fashion could further enhance outcomes.

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