Endovenous Radiofrequency Ablation of Superficial and Perforator Veins

Roth, Steven M.

doi:10.1016/j.suc.2007.07.009

Cited by 27 publications

(23 citation statements)

References 44 publications

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“…EVOLEeS [2] trial showed a neovascularisation rate of 3% with conventional closure technique and 17% with stripping. The present technique also has a positive potential on the overall cost of treatment because of the immediate ambulation compared to more than 2 weeks of no work and hospitalisation by doing a traditional surgery [10]. 95% patients in the present study returned to normal activities within one day of the closure fast procedure; this outcome was observed to be even better than that shown by EVOLVeS [2] using the conventional closure technique where 80% patients resumed their activity after 24 hours of procedure compared to only 47% by stripping.…”

Section: Discussionmentioning

confidence: 95%

Endovenous Ablation of Saphenofemoral Insufficiency: Analysis of 100 Patients Using RF Closure Fast Technique

Kapoor¹,

Mahajan²

2010

Indian J Surg

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Chronic venous insufficiency is a common problem leading to varicose veins of lower limbs which was traditionally being treated with ligation and stripping. Endovenous ablation is an attractive alternative minimally invasive technique to treat such patients. We analysed the results of 100 consecutive patients treated with Radiofrequency based endovenous ablation using Closure Fast Catheter. Retrospective analysis of 100 consecutive patients with chronic venous insufficiency treated at our institution was done. All patients were classified pre and post procedure based on clinical, etiologic, anatomic and pathophyslogical classification, Venous clinical severity and Venous disablitity scores alongwith color doppler examination with follow up done at 2 weeks, 3 months and one year for any disease recurrence or residual symptoms. 97 of the 100 patients treated at 3 months and at 1 year showed good reduction of venous clinical severity and Venous disability scores to 0. Doppler showed complete closure of saphenofemoral junction and long saphenous vein at 2 weeks with no recanalisation at one year. No thrombus formation was observed. Minor complications like ecchymosis was seen in 9 patients and thrombophlebitis in 4 patients. Endovenous ablation using radiofrequency with Closure Fast technique showed improved short and long term results in patients with venous insufficiency with 100% closure seen on doppler studies along with lesser complications and no thrombus formation due shortened procedure time and improved catheter design.

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Section: Discussionmentioning

confidence: 95%

Endovenous Ablation of Saphenofemoral Insufficiency: Analysis of 100 Patients Using RF Closure Fast Technique

Kapoor¹,

Mahajan²

2010

Indian J Surg

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“…3 Subsequently, shrinkage and contraction of the vein wall ensues. 5 One of the unique complications of this treatment can be the formation of thrombus in the proximal GSV, which may extend for varying degrees into the femoral vein lumen.…”

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confidence: 99%

Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning

Haqqani

Vasiliu

O’Donnell

et al. 2011

Journal of Vascular Surgery

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“…15, 35–37 Side effects of perforator ablation include ecchymosis, induration, and pain in the majority of cases, while paresthesias, hyperpigmentation, and phlebitis occur in the minority of cases. 27, 38, 39 Multiple needle punctures during sclerotherapy can lead to vasospasm or hematoma, but in our population, the common side effects seen during ablation were minimal. Patients tolerated sclerotherapy much more comfortably than ablation therapy and often recover faster.…”

Section: Discussionmentioning

confidence: 66%

Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux

Kiguchi

Hager

Winger

et al. 2014

Journal of Vascular Surgery

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OBJECTIVES Refluxing perforators contribute to venous ulceration. We sought to describe patient characteristics and procedural factors that (1) impact rates of incompetent perforator vein (IPV) thrombosis with ultrasound-guided sclerotherapy (UGS) and (2) impact the healing of venous ulcers (CEAP 6) without axial reflux. METHODS Retrospective review of UGS of IPV injections from 1/2010–11/2012 identified 73 treated venous ulcers in 62 patients. Patients had no other superficial/axial reflux and were treated with standard wound care and compression. Ultrasound was used to screen for refluxing perforators near ulcer(s), and these were injected with sodium tetradecyl sulfate or polidocanol foam and assessed for thrombosis at 2 weeks. Demographic data, comorbidities, treatment details and outcomes were analyzed. Univariate and multivariable modeling was performed to determine covariates predicting IPV thrombosis and ulcer healing. RESULTS 62 patients with active ulcers for an average of 28 months with compression therapy prior to perforator treatment had an average age of 57.1 years, were 55% male, 36% had a history of DVT and 30% had deep venous reflux. 32 patients (52%) healed ulcers, while 30 patients (48%) had non-healed ulcer(s) in mean follow-up of 30.2 months. Ulcers were treated with 189 injections, with average thrombosis rate of 54%. Of 73 ulcers, 43 ulcers healed (59%), and 30 ulcers did not heal (41%). Patients that healed ulcers had an IPV thrombosis rate of 69 % vs. 38% in patients who did not heal (P<.001). Multivariate models demonstrated male gender and warfarin use negatively predicted thrombosis of IPVs (P=.03, P=.01). Multivariate model for ulcer healing found complete IPV thrombosis was a positive predictor (P=.02), while large initial ulcer area was a negative predictor (P=.08). Increased age was associated with fewer ulcer recurrences (P=.05). Hypertension and increased follow-up time predicted increased ulcer recurrences (P=.04, P=.02). Calf vein thrombosis occurred after 3% (6/189) of injections. CONCLUSIONS Thrombosis of IPVs with UGS increases venous ulcer healing in a difficult patient population. Complete closure of all IPVs in an ulcerated limb was the only predictor of ulcer healing. Men and patients on warfarin have decreased rates of IPV thrombosis with UGS.

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Endovenous Radiofrequency Ablation of Superficial and Perforator Veins

Cited by 27 publications

References 44 publications

Endovenous Ablation of Saphenofemoral Insufficiency: Analysis of 100 Patients Using RF Closure Fast Technique

Endovenous Ablation of Saphenofemoral Insufficiency: Analysis of 100 Patients Using RF Closure Fast Technique

Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning

Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux

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