Interventions for great saphenous vein incompetence

Whing, Jade; Nandhra, Sandip; Nesbitt, Craig; Stansby, Gerard

doi:10.1002/14651858.cd005624.pub4

Cited by 40 publications

(37 citation statements)

References 117 publications

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“…Comparing the procedure type, the frequency of recurrences is uncertain. While some studies conclude that, at a five-year follow-up, a significantly higher varicose vein recurrence rate appeared after EVLA compared to surgery [ 28 , 29 , 30 ], some papers claim that recurrence was comparable between those techniques within a period of three years and after five years [ 31 , 32 ], and no significant difference was determined regarding the recurrence rate in the comparison of radiofrequency ablation to surgery or endovenous laser therapy [ 33 ]. Comparing our data with respect to recurrence rate to another recent study presenting GSV stripping, the results are quite similar [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Matei

Anghel

et al. 2022

JCM

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Objective: The presentation of cryostripping as an alternative procedure useful in venous insufficiency treatment. Methods: This retrospective study presents the results of 1087 operated patients, including follow-ups. Cryostripping was practised in all mentioned cases. Patient follow-up was performed at one week, one month, and six months postoperatively by clinical examination, Doppler ultrasonography, CIVIQ-20 and r-VCSS questionnaires. Outcomes, complications, surgery and hospitalisation period, and benefits of the method were analysed. Results: Generally, good functional and aesthetic outcomes defined by clinical symptom remission, absence of insufficient veins on Doppler ultrasonography, QoL and r-VCSS improvement (p < 0.001) were obtained. Complications included bruising ⌀ < 2 cm (32.38%), haematoma (8.92%), saphenous nerve injury (3.49%), deep vein thrombosis (0.18%). Recurrence was noted in 2.94% cases. Mean duration of procedure was 42 ± 12.5 min, mean duration of hospitalisation was 1.05 ± 0.36 days. Compared to high ligation and conventional stripping, the postoperative complications were reduced; compared to other minimally invasive procedures, the costs were reduced. Conclusions: Cryostripping seems to combine the radicality and efficacy of the stripping technique with the cosmetic advantage of the endothermal procedures, being an effective therapeutic method perfectly adapted to the economic conditions of middle-income countries health system. It is also suitable as day-case surgery.

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Section: Discussionmentioning

confidence: 99%

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Matei

Anghel

et al. 2022

JCM

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“…According to the most recent meta-analyses, 13,14,15,16 despite MOCA shows slightly poorer vein closure and recanalization rates than thermal endovenous ablation procedures, clinical outcomes, quality of life improvement, and patient satisfaction are similar. Recovery time was slightly reduced with nonthermal procedures, and patient satisfaction does not sensibly differ.…”

Section: Discussionmentioning

confidence: 99%

Selective crossectomy combined with mechanochemical ablation in the treatment of great saphenous vein insufficiency: Early results of a single center experience

et al. 2022

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Background Selective crossectomy and mechanochemical ablation (MOCA) of great saphenous vein (GSV) have been used, for years, individually in the treatment of chronic venous insufficiency. In this paper, we focus on the advantages of a combination of the two techniques, in order to prevent complications and recurrence. Methods A preoperative clinical and instrumental screening phase was conducted for the purpose of dividing patients into three groups: “Saph+Cross” group (51/139 patients) underwent saphenectomy and crossectomy; “MOCA” group (44/139 patients) underwent MOCA of GSV with Flebogrif® device; “MOCA + Cross” group (44/139 patients) subjected to both MOCA and crossectomy procedures. Recurrence rate, defined as total recanalization of GSV and/or onset of neosaphena and/or new varicose veins, was used as a primary outcome. Secondary outcomes were procedural time and intra- and post-procedural complications. Results We conducted a 1-, 6-, and 12-month follow-up with Duplex scan. The recurrence rates were 3.9%, 21.8%, and 4.5% for “Saph+Cross,” “MOCA,” and “MOCA+Cross,” respectively, with a significant difference for the comparison between “MOCA” and “Saph+Cross” (MOCA vs Saph+Cross: OR 5.35, CI95% [0.98; 54.6], p-value .040). The sub-analysis of primary outcome highlighted a lower recanalization rate of GSV when combining the crossectomy with MOCA procedure (2.2% MOCA+Cross vs 15.9% MOCA; 0.12 OR, [0.002; 1.02] CI95%, p-value .029). Among the secondary outcomes, “MOCA” showed a shorter procedural time than the other groups (Saph+Cross: 51.3 ± 11.4; MOCA: 45.1 ± 7.5; MOCA+Cross: 50.4 ± 10; p-value .027). No significant differences were noted in terms of intra- and post-procedural complications. Conclusions The results showed that patients treated with saphenectomy and crossectomy have a lower recurrence rate compared to MOCA alone and MOCA + crossectomy procedures. The association of crossectomy with MOCA significantly reduces the recanalization rate of GSV, and it is also characterized by a higher free survival from recurrence (SSF) than with MOCA alone.

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“…For EVTA, several long term result reports of RCTs comparing EVLA and/or RFA with HLS or UGFS, with a follow up of at least five years after GSV treatment, have been published. 200 In a meta-analysis, three RCTs and 10 RCT follow up studies were included and data were pooled to determine anatomical success as primary outcome. 201 The pooled anatomical success rate was 88% (95% CI 82 e 92%) after EVLA versus 83% (95% CI 72 e 90%) after HLS and 34% (95% CI 26 e 44%) after UGFS.…”

Section: ) the Technique Is Similarmentioning

confidence: 99%

“…As already discussed in subsection 4.2.1.2, long term (five year) results of EVTA and HLS are not different with respect to clinical VV recurrence or recurrent reflux detected by DUS, although the site of recurrence may be different. 134,177,200,202,203 In addition, a meta-analysis looked at pooled long term outcome data (five years) of two RCTs and 10 follow up studies of RCTs on treatment of GSV incompetence. Recurrent reflux rates at the SFJ were statistically significantly lower after HLS than after EVLA (12%, 95% CI 7 e 20% vs. 22%, 95% CI 14 e 32%; p ¼ .038).…”

Section: Class Level References Toementioning

confidence: 99%

European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs

Nyamekye

2022

JMV-Journal de Médecine Vasculaire

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Interventions for great saphenous vein incompetence

Cited by 40 publications

References 117 publications

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Selective crossectomy combined with mechanochemical ablation in the treatment of great saphenous vein insufficiency: Early results of a single center experience

European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs

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