scholarly journals Ultrasound-Guided Sclerotherapy of the Great Saphenous Vein with 1% vs. 3% Polidocanol Foam: A Multicentre Double-Blind Randomised Trial with 3-Year Follow-Up

2010 ◽  
Vol 39 (6) ◽  
pp. 779-786 ◽  
Author(s):  
S. Blaise ◽  
J.L. Bosson ◽  
J.M. Diamand
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Randomised Trial ◽  
Ultrasound Guided ◽  
Double Blind

Endoluminal thermal ablation of the great saphenous vein (GSV) insufficiency

Phlebologie ◽  
2016 ◽  
Vol 45 (06) ◽  
pp. 357-362 ◽  
Author(s):  
C. Zollmann ◽  
P. Zollmann ◽  
J. Veltman ◽  
A. Gräser ◽  
I. Berger ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Laser Ablation ◽  
Prospective Study ◽  
Saphenous Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Treatment Technique ◽  
Ultrasound Guided ◽  
Previously Treated

SummaryTo evaluate and compare the fiveyear outcome after treatment of a varicose GSV by endovenous thermal laser ablation (EVLA) and radiofrequency ablation (RFA).In this non-randomized, prospective study, patients treated in 2007 and 2008 for complete varicosis of the GSV (CEAP: C2–C6) were divided according to the treatment technique used into three groups: RFA (VNUS ClosureFast™), EVLA 980 nm (ELVeS 980™) and EVLA 1470 nm (ELVeS 1470™). Ultrasound-guided follow-up consultations were conducted 3 days, 3 months, 1 year and 5 years after treatment.589 patients with 643 GSVs (223 RFA, 185 EVLA 980, 235 EVLA 1470) were treated under tumescent local anaesthesia. No major complications occurred and minor complications were rare (4.7–12.2 %, p=0.135).66 % (RFA), 15 % (EVLA 980) and 32 % (EVLA 1470) of the patients were pain-free without post-operative analgesics. After 5 years, 86 % (RFA), 90 % (EVLA 980) and 93 % (EVLA 1470) of the veins were occluded (p=0.096). Ultrasound imaging revealed reflux in treated GSVs in 5–8 % of cases (p=0.73). A second ablation of the previously treated GSV was required in 5 % (RFA), 2 % (EVLA 980) and 2 % (EVLA 1470) of the patients (p=0.28).Endoluminal thermal ablation is an easy, safe and well tolerated method for the treatment of varicosis. Radiofrequency ablation is less painful than EVLA. RFA and EVLA 1470 are equally effective for vein closure.

Predictors of recurrence of great saphenous vein reflux following treatment with ultrasound-guided foamsclerotherapy

2014 ◽  
Vol 30 (3) ◽  
pp. 194-199 ◽  
Author(s):  
N Shadid ◽  
P Nelemans ◽  
J Lawson ◽  
A Sommer
Keyword(s):  
Saphenous Vein ◽  
Cox Regression ◽  
Great Saphenous Vein ◽  
Controlled Trial ◽  
Clinical Severity ◽  
Ultrasound Guided ◽  
Cox Regression Analysis ◽  
Venous Clinical Severity Score ◽  
Vein Reflux

Objective To investigate which clinical characteristics at baseline are predictive for great saphenous vein recurrence following ultrasound-guided foamsclerotherapy. Material and methods Data of patients treated for great saphenous vein incompetence with ultrasound-guided foamsclerotherapy were derived from a multicentre prospective randomized controlled trial comparing surgery versus ultrasound-guided foamsclerotherapy with a follow-up of two years. Recurrence of reflux was determined on colour duplex scans at three months, one year and two years. Univariate and multivariate Cox regression analysis was used to evaluate the effect of gender, age, C of CEAP classification, diameter of great saphenous vein, injected foam volume, presence of distal great saphenous vein reflux, presence of reflux in the anterior accessory saphenous vein and Venous Clinical Severity Score on risk of recurrent reflux. Results Two hundred twenty-five patients were available for analysis. Treatment after one single session was successful in 120 patients and recurrence of saphenous reflux was observed in 105 patients within two years during follow-up. Significant associations with risk of recurrence were observed for mid thigh great saphenous vein diameter (HR = 1.012 with 95% CI: 1.002–1.022, p = 0.022) and presence of distal great saphenous vein reflux (HR = 1.882 with 95% CI: 1.029–3.443, p = 0.040). Conclusion In conclusion, this prospective study suggests that ultrasound-guided foamsclerotherapy treatment for the proximal great saphenous vein is less effective for patients with a large vein and a refluxing distal great saphenous vein at baseline.

scholarly journals Treatment of varicose great saphenous veins with saphenofemoral junction insufficiency – what is the evidence? *

Phlebologie ◽  
2020 ◽  
Vol 49 (02) ◽  
pp. 87-97
Author(s):  
René Gordon Holzheimer ◽  
Alfred Obermayer ◽  
Thomas Noppeney
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
High Ligation ◽  
Ultrasound Guided ◽  
Endovenous Laser Ablation ◽  
Randomized Controlled ◽  
Randomized Studies ◽  
Randomized Controlled Studies

AbstractThe results of studies on treatment of the great saphenous vein (GSV) with sapheno-femoral-junction (SFJ) insufficiency are unclear. Guidelines, however, recommend endovenous laser ablation (EVLA) and ultrasound-guided-foamsclerotherapy (UGFS) for symptomatic varicose large saphenous vein. There are numerous studies on GSV treatment but only a few randomized studies with a follow-up of two years and more. Meta-analyses in most instances included all studies and do not focus on studies with a follow-up of two years and longer. Methods A literature research in Pubmed used the keyword “great saphenous vein treatment”, “large saphenous vein treatment”, “varicose therapy” in conjunction with “randomized controlled trial”, “meta-analysis” and “systematic review”. Of 128 studies only 24 randomized controlled studies investigated the effect of High Ligation and Continuous Stripping (HL + CS), Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA), Liquid Sclerotherapy (LS), and Ultrasound-Guided-Foam-Sclerotherapy (UGFS) and a follow-up of two and more years. Study evaluation included “reflux”, “recurrence”, “therapy technique”, numbers of patients/legs treated, length of follow-up, and primary/secondary study endpoints. Results Most of these studies investigated surgical High Ligation and Continuous Stripping (HL + CS) with a follow-up of two years and more. This technique served a reference technique for other techniques in randomized controlled studies. However, there are major differences in techniques, mode of treatment, definitions, criteria for exclusion and inclusion, and study endpoints.The surgery study group included 1915 legs in 19 studies, the EVLA group 1047 legs in 12 studies and 240 legs in 3 studies with combined HL + EVLA treatment. RFA was used in 299 legs in 4 studies, UGFS in 661 legs in 5 studies, combined UGFS + HL in 39 legs and LS + HL in 92 legs in one study each.EVLA is associated with more reflux and recurrence when compared to HL + CS. RFA shows similar reflux and recurrence rates as surgery. In most studies UGFS and LS is followed by more reflux and recurrence when compared to surgery. Conclusion Due to heterogeneity of studies comparing study results of HL + CS, EVLA, RFA, LS and UGFS is not reliable. UIP or ECOP may form a commission to establish uniform, reliable and accepted study designs for varicose vein treatment to improve comparability of further randomized studies.

Catheter-directed foam sclerotherapy with tumescence of the great saphenous vein versus ultrasound-guided foam sclerotherapy: A randomized controlled trial

2019 ◽  
Vol 35 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Jorgete B dos Santos ◽  
Walter Campos Júnior ◽  
Rina MP Porta ◽  
Juliana Puggina ◽  
Daniela FT da Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Success Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Number Of Patients

Objectives To compare the effectiveness of two foam sclerotherapy techniques of the great saphenous vein. Methods Fifty subjects with varicose veins, edema, and great saphenous vein incompetence (diameter 6–10 mm) were randomly categorized into two equal groups and were treated with different foam sclerotherapy techniques: A (usual ultrasound-guided) and B (catheter-directed with tumescence). Concomitant phlebectomy was performed in all patients. Patients were seen on days 7 and 28, and at six and 12 months. The primary outcomes were the full success rate of the treated great saphenous vein and the number of patients who required retreatment sessions performed at 28-day follow-up. The secondary-assisted outcomes were the full success rates of the treated great saphenous vein after the retreatment sessions at six- and 12-month follow-up. Secondary outcomes were changes in quality of life and side effects and complications of the intervention. In case of reflux, retreatment sessions were performed at 28 days and six months in both groups. Results Full success rate of the treated great saphenous vein was 36% in group A vs. 80% in group B ( p = 0.012) and the number of patients who required retreatment sessions were n = 14 in group A vs. n = 3 in group B at 28-day follow-up ( p = 0.002). Both were statistically significant. At six and 12 months, the success rates were not statistically significant between the groups. Complication rates were similar between the groups. Quality of life improved in both groups with statistical difference ( p < 0.001). Conclusions Catheter-directed foam sclerotherapy with tumescence was better than usual ultrasound-guided foam sclerotherapy as it reached higher full success rate of the treated great saphenous vein and as a lower number of patients required retreatment sessions in the short-term. Both methods proved to be safe and improved the quality of life.

scholarly journals LEV 12. Small-Diameter Recanalization of the Great Saphenous Vein After Ultrasound-Guided Foam Sclerotherapy: Three-Year Follow-up

2019 ◽  
Vol 70 (5) ◽  
pp. e173
Author(s):  
Jean-Luc Gillet ◽  
Michel Lausecker ◽  
Claudine Hamel-Desnos ◽  
François André Allaert
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Small Diameter ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy
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