Transilluminated Powered Phlebectomy in the Treatment of Varicose Veins

Passman, Marc A.

doi:10.2310/6670.2007.00063

Cited by 21 publications

(21 citation statements)

References 16 publications

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“…The addition of small 1.5-mm punch incisions allows for blood that collects in the vein tract to be flushed out with further tumescent anesthetic fluid. [184][185][186] Preservation of the GSV. Preservation of the saphenous vein and treatment of varicose tributaries by phlebectomy has been advocated by Francesci in the CHIVA (cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatiore [ambulatory conservative hemodynamic management of varicose veins]) technique [186][187][188][189] and by Pittaluga in the ASVAL (ablation sélective des varices sous anesthésie locale [ie ambulatory selective varicose vein ablation under local anesthesia]) technique.…”

Section: Open Venous Surgerymentioning

confidence: 98%

“…Transilluminated powered phlebectomy (TIPP; Trivex, InaVein, Lexington, Mass), an alternative technique for the removal of varicose veins, is especially useful for the removal of larger clusters of varicosities. 184,185 The potential advantages of TIPP include a decrease in the number of incisions and much faster removal of a large amount of varicose vein tissue. Just as for ambulatory phlebectomy, TIPP is often combined with saphenous vein ablation procedures or stripping and ligation to eliminate the source of the reflux underlying a varicose venous cluster formation.…”

Section: Open Venous Surgerymentioning

confidence: 99%

See 1 more Smart Citation

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,298

952

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The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping of the saphenous vein to the level of the knee (GRADE 1B). We recommend phlebectomy or sclerotherapy to treat varicose tributaries (GRADE 1B) and suggest foam sclerotherapy as an option for the treatment of the incompetent saphenous vein (GRADE 2C). We recommend against selective treatment of perforating vein incompetence in patients with simple varicose veins (CEAP class C(2); GRADE 1B), but we suggest treatment of pathologic perforating veins (outward flow duration ≥500 ms, vein diameter ≥3.5 mm) located underneath healed or active ulcers (CEAP class C(5)-C(6); GRADE 2B). We suggest treatment of pelvic congestion syndrome and pelvic varices with coil embolization, plugs, or transcatheter sclerotherapy, used alone or together (GRADE 2B).

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Section: Open Venous Surgerymentioning

confidence: 98%

Section: Open Venous Surgerymentioning

confidence: 99%

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,298

952

View full text Add to dashboard Cite

show abstract

“…The patient in the present report underwent RFA of the GSV in combination with transilluminated power phlebectomy. Complications following transilluminated power phlebectomy vary considerably and consist primarily of ecchymosis and/or hematoma formation (4.9% to 95%), paresthesias or nerve injury (9.5% to 39%), skin perforation (1.2% to 5%), superficial phlebitis (2.4% to 13%), swelling (5% to 17.5%), hyperpigmentation (1.2% to 3.3%), and DVT (<1%) [11]. Passman et al [12] compared the overall complication rate between combined saphenous stripping-stab avulsion phlebectomy, strippingtransilluminated-powered phlebectomy, and endovenous ablationtransilluminated-powered phlebectomy.…”

Section: Discussionmentioning

confidence: 99%

Stroke Following Radiofrequency Ablation of the Great Saphenous Vein

Kunstmann¹

2014

J Vasc Med Surg

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“…TIPP was performed using a TriVex system (Smith and Nephew Inc., MA, USA) as previously described . The great saphenous vein was stripped using a conventional phlebectomy procedure before the TriVex procedure.…”

Section: Methodsmentioning

confidence: 99%

Transilluminated powered phlebectomy in the treatment of large area venous leg ulcers: A case‐control study with 3 years follow‐up

Chen

Zeng

et al. 2019

Microcirculation

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Objective: To evaluate the efficacy, safety and long-term outcome of TIPP for the adjunct therapy of superficial venous reflux-related VLUs.Methods: A total of 93 consecutive patients (104 legs) with superficial venous insufficiency-related VLUs who underwent TIPP (53 legs) or conventional phlebectomy (51 legs) between January 2010 and December 2013 were retrospectively studied.Results: Compared to patients in the conventional phlebectomy group, TIPP patients had larger ulcer areas before surgery (P < 0.005). However, TIPP group required a significantly shorter operation time (P < 0.005), fewer incisions (P < 0.005) but less ulcer healing time (1.25 month vs 2.5 months, P < 0.05). No significant difference in in-hospital and follow-up complications was found between the two groups. For long-term outcome, TIPP group leaded a lower ulcer recurrence rate at 36 months (13.2% vs 29.4%, P < 0.05). Conclusion:TIPP may be an adjunct surgical method contributes to healing of VLUs, especially for large ulcer areas. K E Y W O R D Schronic venous ulcers, TIPP, TriVex, venous surgery

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Transilluminated Powered Phlebectomy in the Treatment of Varicose Veins

Cited by 21 publications

References 16 publications

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Stroke Following Radiofrequency Ablation of the Great Saphenous Vein

Transilluminated powered phlebectomy in the treatment of large area venous leg ulcers: A case‐control study with 3 years follow‐up

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