Minimally invasive treatments for perforator vein insufficiency

Kuyumcu, Gokhan; Salazar, Gloria M.; Prabhakar, Anand M.; Ganguli, Suvranu

doi:10.21037/cdt.2016.11.12

Cited by 24 publications

(19 citation statements)

References 41 publications

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“…The experiences gathered in clinical studies have also demonstrated that incompetent PVs are likely to be more important in the development of VVs [2,10,23]; if incompetent PVs can be selectively treated, more satisfactory results could be achieved [19,22]. Several authors suggest treating incompetent PVs in cases of focal swelling, pain, associated VVs, focal skin irritation, discoloration, venous ulceration in the area of the incompetent PVs, clinical severity, etiology, anatomy, and pathophysiology score more than four [24]. In particular, treatment of incompetent PV is recommended in which the VV is non-saphenous and starts from the periphery of incompetent PV.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with a combination of SVI and PVI, routine PVI treatment is recommended by some authors, along with SVI treatment because of the risk of recurrence [6,[25][26][27]. Incompetent PVs can be treated with surgical ligation, US-guided sclerotherapy, endovascular thermal, laser therapy, or radiofrequency ablation [24]. It is still not known whether preoperative identification of PVI could facilitate more effective treatment.…”

Section: Discussionmentioning

confidence: 99%

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Frequency and Significance of Perforating Venous Insufficiency in Patients with Chronic Venous Insufficiency of Lower Extremity

Tolu¹,

Durmaz²

2018

Eurasian J Med

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Objective: The aim of this study was to reveal the frequency and impact of perforating venous insufficiency (PVI) in chronic venous insufficiency (CVI) of lower extremity (LE). Results: PVI was revealed in 27.5% (n=571) of LEs. Varicose veins (VVs) related with perforating vein (PV) were revealed in 44.7% of LEs (n=929). PVI was observed in 50.91% of patients with chronic deep venous thrombosis (DVT), 64.41% with deep venous insufficiency (DVI), 59.81% with great saphenous vein (GSV) insufficiency, 68.49% with small saphenous vein (SSV) insufficiency, 58.65% with accessory GSV insufficiency, and 58.77% with PV associated with VVs. There was a statistically significant relationship between PVI and chronic DVT, DVI, GSV, SSV, and accessory GSV insufficiency (p<0.001). A significant relationship was observed between the increase in PV diameter and the presence of PVI (p<0.001). Materials and MethodsConclusion: PVI is quite common in combined VI, and PV evaluation should be a part of LE venous system examination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Frequency and Significance of Perforating Venous Insufficiency in Patients with Chronic Venous Insufficiency of Lower Extremity

Tolu¹,

Durmaz²

2018

Eurasian J Med

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“…There are a variety of minimally invasive techniques and treatment modalities, including ultrasound-guided sclerotherapy and endovascular thermal ablation with laser or radiofrequency energy. These techniques can be performed in an office setting with local anaesthesia 23…”

Section: Methodsmentioning

confidence: 99%

Protocol for a systematic review and meta-analysis of interventions for pathologic perforator veins in chronic venous disease

Silva¹,

Flumignan

Miranda

et al. 2019

BMJ Open

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IntroductionPerforator veins (PVs) play an important role in the development of chronic venous insufficiency and ulceration. Procedures to eliminate incompetence and reflux in PV may include open surgery, subfascial endoscopic surgery, intravenous ablation techniques and sclerotherapy. With the aim of filling the evidence gap, this is a protocol for a systematic review that will assess the effects of any form of intervention for the treatment of pathologic PVs of the lower limbs in patients with chronic venous disease.Methods and analysisSystematic searches will be carried out in MEDLINE, EMBASE, Cochrane CENTRAL, IBECS and LILACS databases at a minimum without date or language restrictions for relevant randomised controlled trials (RCTs) and quasi-RCTs (trials in which the method of allocation is not truly random). In addition, a search will also be carried out in the WHO International Clinical Trials Registry Platform, in the clinical trial registries of ClinicalTrials.gov and in the grey literature source OpenGrey.eu. The RCT and quasi-RCT comparison techniques isolated or in combination for treating PVs will be considered. Three review authors will independently perform data extraction and quality assessments of data from included studies, and any disagreements will be resolved by discussion. The primary outcomes will be wound healing and pain. Secondary outcomes will include oedema, adverse events, recurrence or recanalisation, quality of life and economic aspects. The Cochrane handbook will be used for guidance. If the results are not appropriate for a meta-analysis in RevManV.5 software (eg, if the data have considerable heterogeneity and are drawn from different comparisons), a descriptive analysis will be performed.Ethics and disseminationEthics committee approval is not necessary. We intend to update the public registry used in this review, report any important protocol amendments and publish the results in a widely accessible journal.PROSPERO registration numberCRD42018092974

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“…This involves a greater learning curve with the technology and higher costs of equipment. However, numerous studies have demonstrated higher perforator closure rates with the use of thermal ablation compared to UGFS [12]. The reported closure rates have been as high as 95% [13].…”

Section: Endo Venous Thermal Ablation (Evta)mentioning

confidence: 99%

Incompetent Perforator Veins; To treat or not to treat

Gunawardena¹,

Gunawansa²

2019

Int J Vasc Surg Med

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The role of perforator vein incompetence (PVI) in the development of venous hypertension, chronic venous insuffi ciency (CVI) and ulceration has been well recognized for over a century. However, while minimally invasive endovenous ablative therapies have revolutionized the management of superfi cial truncal vein insuffi ciency, the defi nitive indications for intervention and management of PVI still remains somewhat debatable and unclear. This review will attempt to clarify the indications for intervention as well as look at the evidence for different methods of treatment in established PVI.

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Minimally invasive treatments for perforator vein insufficiency

Cited by 24 publications

References 41 publications

Frequency and Significance of Perforating Venous Insufficiency in Patients with Chronic Venous Insufficiency of Lower Extremity

Frequency and Significance of Perforating Venous Insufficiency in Patients with Chronic Venous Insufficiency of Lower Extremity

Protocol for a systematic review and meta-analysis of interventions for pathologic perforator veins in chronic venous disease

Incompetent Perforator Veins; To treat or not to treat

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