Endovascular versus medical treatment of venous compression syndrome of the iliac vein – a systematic review

Summary: The treatment of non-thrombotic iliac vein lesions (NIVL) remains debatable with many advocating conservative treatments, whilst others offering venous stenting. The objective of this review was to systematically assess the treatment options for symptomatic iliac vein compression syndrome (IVCS) in patients without evidence of thrombotic disease at the time of diagnosis. An online search of published literature looking for randomised controlled trials and observational studies that evaluated the treatment for symptomatic NIVL was performed. Nine studies were included with a total 953 patients of which 782 patients had NIVL. Patency rates ranged between 94.8%–100% in the first month, 88.2%–94.1% in six months and 73.4%–98% in 12 months, in patients with NIVL post stenting. Longer follow-up of up to 5 years shows promising patency rates of 94% in patients with IVCS. Patients with IVCS are likely to benefit from a combination of endovenous treatment at the time of diagnosis including stent placement to maintain lumen patency and prevent recurrent deep venpus thrombosis and/or postthrombotic syndrome.

100 Months Experiences With VenaSeal® Vein Glue: Long Time Follow - Up Study Conducted On 2912 Truncal Saphenous Veins In 1509 Cases

The paper is about long - time experiences in treatment of truncal varicose veins with the vein glue VenaSeal®: 100 months - follow up of 1509 cases and 2912 truncal varicose veins. Since 1999 years by now, varicosis has been increasingly treated endovenously. At the start, the rather inconvenient VNUS® Closure plus - procedure and the more convenient linear laser procedure were used, and these were followed in 2007 by the bipolar RFITT® catheter, the VNUS® Closure Fast system and the radial laser. These endovenous treatment techniques were followed by the Clarivein System and the VenaSeal® System in 2011/2012. Thus, in the course of the last few years, plenty of experience has been gathered with endoluminal therapy, quality criteria have been defined and standards for the different techniques have been developed. The presented actual paper sheds light on the advantages and disadvantages of the vein glue VenaSeal® and presents the 100-months results of a single-center praxis study with prospective design. We will report about our experiences and results of a prospective comparative study of VenaSeal® - Closure in the treatment of 2512 saphenous veins (1949 GSV, 731 SSV, VSAL in 110 cases, VSAM in 87cases, femoropopliteal vein in 33 cases and Giacomini’s vein in 2 cases). Also ulcera crures were included in 17 cases (Figure 1).

Patient injuries in the treatment of superficial venous insufficiency registered in Finland between 2004 and 2017

Objectives This study aimed to identify the unintended incidents that led to patient injuries (PIs) in the treatment of superficial venous insufficiency (SVI). Methods PI claims filed with the Finnish Patient Insurance Centre between 2004 and 2017 involving SVI were reviewed. Factors contributing to PI were identified and classified. Results Eighteen (13.2%) of 136 compensated PIs in the specialty of vascular surgery were related to SVI. Only 4.7% of 383 SVI claims were compensated. The incidence of PIs was 9.9 per 100 000 patients. Fifteen patients had open surgery (83.3%) and three (16.7%) endovenous treatment. Two (11.1%) patients had necrotising fasciitis, four (22.1%) had deep vein injuries and two (11.1%) had a permanent nerve injury. Two (11.1%) patients had retained endovenous material that required surgical removal. Conclusions PIs were identifiable during all stages of care, perioperative injuries related to open surgery being the most common.