The effect of wavelength on endothermal heat-induced thrombosis incidence after endovenous laser ablation

Shutze, William P.; Kane, Katherine; Fisher, Tammy; Doud, Yahya; Lassiter, Grace; Leuking, Richard; Nguyen, Elizabeth

doi:10.1016/j.jvsv.2015.08.003

Cited by 28 publications

(25 citation statements)

References 22 publications

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“…According to the current literature, the main risk factors that play a significant role in the occurrence of a PATE are a large venous diameter >7.5mm, simultaneous phlebectomies and high-grade CEAP classes. The literature concerning the male sex as a risk factor is contradictory (5,6). These parameters could not be confirmed as risk factors in our centre and an elevated BMI, concomitant treatment of the AASV or the duration of post-interventional anticoagulation also do not appear to have a significant influence on PATE occurrence (▶ Tab.…”

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confidence: 74%

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Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])

Schäffer¹,

Weingard²,

Kiderlen³

et al. 2018

Phlebologie

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ZusammenfassungAppositionsthromben sind mit einer Prävalenz von 0,2–6% eine nicht seltene Komplikation nach endovenösen Katheterverfahren. Mögliche Risikofaktoren wurden bislang noch nicht ausreichend untersucht, außerdem fehlen Standards für eine angemessene Prophylaxe und ein einheitliches Therapieschema. Wir haben eine retrospektive Analyse von 2015–2017 bezüglich der Prävalenz sowie möglicher Risikofaktoren für das Auftreten eines Appositionsthrombus nach endovenösen Verfahren im Venenzentrum Freiburg durchgeführt. Die in der Literatur beschriebenen Risikofaktoren wie, Gefäßdurchmesser> 7,5mm, simultane Miniphlebektomien sowie ein erhöhter BMI konnten nicht verifiziert werden. Die Stadieneinteilung und die Bezeichnungen des Appositionsthrombus im internationalen Gebrauch wie EHIT (endovenöse hitzeinduzierte Thrombose) und PASTE (post ablation superficial thrombus extension) sind irreführend, da diese Komplikation auch bei nicht-thermischen Verfahren auftreten kann und es sich um eine Thrombusextension ins tiefe Venensystem handelt. Daher empfehlen wir die modifizierte Bezeichnung PATE (post ablation thrombus extension). Ein PATE 0 entspricht einem planen Verschluss und ist somit ein Therapieerfolg. PATE I beschreibt eine Thrombusextension mit Einengung des Lumens der tiefen Vene bis zu 25%, PATE II bis 50% und PATE III >50%. Eine therapeutische Antikoagulation empfehlen die Autoren ab PATE II mit einer Dauer bis zum Verschwinden des Appositionsthrombus.

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confidence: 74%

“…0.2% of those treated by radiofrequency ablation. PASTE is characterised by the appositional growth of a thrombus into the deep vein (2,3,5,6). Unfortunately, the terms in international use are misleading, because the thrombus extends into the deep vein system and is not a superficial extension.…”

mentioning

confidence: 99%

Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])

Schäffer¹,

Weingard²,

Kiderlen³

et al. 2018

Phlebologie

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“…Interestingly, in case of complications, in which dysfunctional endothelium and local or systemic inflammation play a role (e.g., thrombotic disorders [3]), it is even not entirely clear which procedure, CVT or EVLA, is safer. One thing, which is sure, is that the tendency that can be observed in surgical units recently is the decreasing incidence of some EVLA complications (e.g., deep vein thrombosis [16, 17]), which likely reflects both the rising experience of surgeons in using this technique [18] and technological improvements in surgical devises [19]. These observations may lead to a hypothesis that EVLA has great potential to be less traumatic to cells and tissues than classic techniques.…”

Section: Discussionmentioning

confidence: 99%

Endovenous Laser Ablation of Varicose Veins Preserves Biological Properties of Vascular Endothelium and Modulates Proinflammatory Agent Profile More Favorably Than Classic Vein Stripping

Uruski

Aniukiewicz

Mikuła-Pietrasik

et al. 2017

BioMed Research International

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Here we compared effect of serum from varicose patients undergoing endovenous laser ablation (EVLA) and classic vein stripping (CVS) on biological properties of endothelial cells and on the local and systemic profiles of proinflammatory agents. Results showed that serum from EVLA patients improved proliferation and reduced senescence and oxidative stress in the endothelial cells, as compared with the serum from CVS patients. These effects were related to a suppressed activity of TGF-β1, the level of which in the serum from the EVLA patients was decreased. Medium generated by the cells subjected to EVLA serum contained decreased amounts of ICAM-1, VCAM-1, and E-selectin and increased amount of uPA, whereas the serum itself contained decreased concentrations of ICAM-1, E-selectin, and P-selectin and increased concentrations of uPA, PAI-1, and TFPI. Both EVLA and CVS resulted in diversified patients' reaction with respect to a direction of postprocedure changes in proinflammatory factors' serum level. Analysis of proportions showed that the groups differed remarkably in case of ICAM-1 and ET-1, the level of which declined in a higher fraction of patients treated endovenously. Our findings indicate that EVLA preserves better than CVS the functionality of vascular endothelium and modulates better both local and systemic profile of proinflammatory mediators.

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“…On the other hand, some studies reported that EHIT was not related to large saphenous vein diameter, whereas others indicated that there was no relationship between EHIT and age/sex by adopting lasers differing in wavelength; risk factors for EHIT remain controversial. [6][7][8] Based on blood through heat exchange and influx into the femoral vein, and the temperature of steam bubbles may reduce; therefore, this may markedly influence the area adjacent to the starting point of ablation. This suggests that steam bubbles are involved in the pathogenesis of creeping type, 11) because the incidence of creeping type, involving extension to the deep vein, is high in EVLA patients, and because the length is ≤2 to 3 cm.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Venous Thromboembolism in Patients Undergoing Endovenous Laser and Radiofrequency Ablation of the Saphenous Vein

Kurihara

Hirokawa

Yamamoto

2016

Annals of Vascular Diseases

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Objective: Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are safe and effective treatments for varicose veins caused by saphenous reflux. Deep venous thrombosis (DVT) and endovenous heat-induced thrombosis (EHIT) are known complications of these procedures. The purpose of this article is to investigate the incidence of postoperative DVT and EHIT in patients undergoing EVLA and RFA. Methods: The patients were assessed by clinical examination and venous duplex ultrasonography before operation and at 24-72 hours, 1 month, and 1 year follow-up after operation. Endovenous ablation (EVA) had been treated for 1026 limbs (835 patients) using an RFA; 1174 limbs (954 patients) using a 1470-nm wavelength diode laser with radial two-ring fiber (1470R); and 6118 limbs (5513 patients) using a 980-nm wavelength diode laser with bare-tip fiber (980B). Results: DVT was detected in 3 legs (0.3%) of RFA, 5 legs (0.4%) of 1470R, and 27 legs (0.4%) of 980B. One patient in three symptomatic DVT treated with 980B developed asymptomatic pulmonary embolus. In all, 31 of the 35 DVTs were confined to the calf veins. The incidence of EHIT classes 2 and 3 was 2.7% following RFA procedure, 6.7% after 1470R, and 7.5% after 980B. Conclusion: The incidence of EHIT following EVA was low, especially the RFA procedure. EHIT resolves within 2-4 weeks in most patients. DVT rates after EVA were compared with those published for saphenous vein stripping. (This is a translation of J Jpn Coll Angiol 2015; 55: 153-161.)

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The effect of wavelength on endothermal heat-induced thrombosis incidence after endovenous laser ablation

Cited by 28 publications

References 22 publications

Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])

Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])

Endovenous Laser Ablation of Varicose Veins Preserves Biological Properties of Vascular Endothelium and Modulates Proinflammatory Agent Profile More Favorably Than Classic Vein Stripping

Postoperative Venous Thromboembolism in Patients Undergoing Endovenous Laser and Radiofrequency Ablation of the Saphenous Vein

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