Endovenous Laser Ablation and Sclerotherapy for Treatment of Varicose Veins (original) (raw)
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Endovenous laser treatment for primary varicose veins
Acta chirurgica Belgica
Venous insufficiency of the lower extremities is a highly prevalent condition. Successful treatment of superficial venous insufficiency will most often necessitate treatment of the saphenofemoral junction incompetence with correction of saphenous vein reflux. In the majority of patients it concerns a reflux of the greater saphenous vein. The standard procedure consists of ligation and stripping of the greater saphenous vein combined with with additional phlebectomies or ligation of insufficient perforant veins if necessary. Although the standard procedure is widely known and accepted, the postoperative morbidity and postoperative limitations of activity are high. In this context minimally invasive percutaneous endovenous techniques were developed to improve the patients comfort and faster resumption of work. Among these, endovenous laser ablation of the greater saphenous vein is a relatively new procedure. Percutaneous introduction of a laser fiber into the incompetent vein and abla...
Acta Radiologica, 2011
Background: Superficial venous insufficiency is a common problem associated with varicose veins. Endovenous laser ablation (EVLA) and concomitant ultrasound (US)-guided foam sclerotherapy are recent treatment methods alternative to surgery in the treatment of superficial venous insufficiency. Purpose: To compare the effectiveness of EVLA and concomitant US-guided foam sclerotherapy prospectively in two different subgroups of the disease (isolated truncal vs. truncal with perforating vein insufficiency). Material and Methods: The study was approved by the institutional review board. Fifty-five patients with symptomatic saphenous vein insufficiency and varicose veins were included in the study. Seventy-three EVLA and concomitant foam sclerotherapy were performed for 60 lower extremities. To determine the severity of the venous disease, Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were carried out before and 6 months after the treatment. Patients were followed up clinically and with Doppler ultrasonography for 6 months after the procedures. Results: At the sixth month of the follow-up; the total occlusion rate for the saphenous veins was 98.64% (72/73), and re-canalization rate was 1.36% (1/73). The total occlusion rate for the perforating veins was 75% (18/24), re-canalization rate was 25% (6/24). There was no notable major complication. VCSS and VAS scores were decreased significantly following the treatment (p , 0.05). The patients who had isolated saphenous vein insufficiency (Group I: 36/60) and those who had saphenous and perforating vein reflux (Group II: 24/60) were compared. VAS scores were more prominently decreased after the treatment in the isolated saphenous vein insufficiency group (p , 0.05). VCSS were also decreased more prominently in Group I when compared to Group II. Conclusion: EVLA and concomitant US-guided foam sclerotherapy are effective, safe, and minimally invasive treatment options, yielding good cosmetic and clinical results in both isolated truncal and truncal with perforating vein insufficiency groups. However, clinical results and satisfaction of the patients were remarkably superior in cases with isolated truncal vein insufficiency compared to truncal and perforating vein insufficiency.
Endovenous laser ablation for great saphenous varicose veins
International Surgery Journal, 2019
Background: Endovenous laser ablation (EVLA) is one of the most accepted treatment options for great saphenous varicose veins. The aim of this study was to evaluate the efficacy and safety EVLA in a 12 months follow-up. Methods: Patients with symptomatic great saphenous veins (GSV) reflux were undergo EVLA. The outcome measures the efficacy and safety along the follow up period (12 months). The efficacy assessed by measuring the occlusion rate of the GSV by duplex and by measuring the improvement in the mean venous clinical severity score (VCSS) by clinical examination. The safety assessed by clinical examination to detect the complications. Results: The rate of complete occlusion in the main trunk of the great saphenous vein was 34/35 (97.1%) at 6 and 12 months. The mean VCSS scores improved significantly after the procedure at 6 and 12 months. Complications detected within 1 st week as pigmentation in 3 patients, local hematoma in one patient, and paresthesia in one patient but all complications disappeared within 6 and 12 months. Conclusions: EVLA is an effective and safe procedure for the treatment of varicose great saphenous.
Endovenous Laser Ablation in Chronic Venous Insufficiency – Study Of 50 Cases
journal of medical science and clinical research, 2017
Background and Aims: Chronic vein insufficiency of the lower extremities is one of the most common benign diseases. Surgery was the gold standard in the treatment of varicose veins. For several decades, high ligation at the sapheno-femoral junction (SFJ) and stripping of the GSV was the treatment of choice to eradicate the diseased vein. Insufficiency of the small saphenous vein (SSV) is treated in a similar way, by ligation at the sapheno-popliteal junction (SPJ) and stripping. In 1999, the first report on EVLA appeared in the literature. Endovenous laser ablation (EVLA) is a well-established treatment for chronic venous insufficiency. As India is developing country patients with chronic venous insufficiency usually present to clinician in advanced stages, so we must modify the technique accordingly. We are presenting our experience of EVLA in 50 cases. Methods and Materials: Fifty patients were treated under spinal anesthesia in single centre by team of radiologist and surgeon over a period of 8 months (Jan 2015-Aug 2015). The greater saphenous vein and lesser saphenous veins treated by EVLA. This is a prospective observational study to determine whether EVLA could be used to treat saphenous veins in chronic venous insufficiency. The indications for treatment was varicosities [ n = 28], leg edema [ n = 9], varicosities and pain [n = 8], varicosities and ulcer [ n= 5]. 7 In 28 patient EVLA was done in both lower limbs and in 22 patients unilateral limb treatment was done. lower 78 greater saphenous veins and 65 lesser saphenous veins were treated in 50 patients. Results: Out of 143 veins single puncture was sufficient in 122 [85%], Two punctures were required in 21 cases [ 15%]. Treatment was successful in 126 venous segments (88%) in first setting, the residual veins were treated in second setting resulting in 100% obliteration. After treatment, ultrasound surveillance within the next few days confirmed that the saphenous veins and tributaries were all occluded. Bruising noted along the course of treated veins. Neuropraxia noted in leg in all the cases for variable period of 2 weeks to 4 months along the course of saphenous vein and sural nerve. There was no late sequel such as persisting induration or fat atrophy. Conclusion: The greater and lesser saphenous veins can be treated by EVLA in single setting in all the cases without any significant complications. It is safe, cost effective with a comfortable recovery while maintaining minimally invasive treatment.
Systematic review of endovenous laser treatment for varicose veins
Background: The safety and effectiveness of endovenous laser treatment (EVLT) for varicose veins are not yet fully evaluated. Methods: Medical bibliographic databases, the internet and reference lists were searched from January 1966 to September 2004. Only case series were available for inclusion in the review. Results: Thirteen studies met the inclusion criteria. Self-limiting features, such as pain, ecchymosis, induration and phlebitis, were commonly encountered after treatment. Deep vein thrombosis and incorrect placement of the laser in vessels were uncommon adverse events. No study has yet assessed the effectiveness of laser therapy in comparison to saphenofemoral junction ligation with saphenous vein stripping. Occlusion of the saphenous vein and abolition of venous reflux occurred in 87·9-100 per cent of limbs, with low rates of re-treatment and recanalization.
Varicose Vein Therapy: Endovenous Laser Ablation
International Journal of Progressive Sciences and Technologies, 2023
Endovenous laser ablation (EVA) is utilized in the therapy and the management of varicose veins from chronic venous disease. The fundamental sign for this treatment is disease that is refractory to conservative treatment with compression stockings. This activity audits the treatment of varicose veins with endovenous laser treatment and features the role of the interprofessional group being taken care of by patients that go through this method. Targets: • Distinguish the indications of varicose vein endovenous laser treatment. • Depict the procedure engaged in varicose vein endovenous laser treatment. • Audit the expected complexities and clinical significance of varicose vein endovenous laser treatment. • Frame interprofessional team techniques for further developing care coordination and correspondence to upgrade the care of patients that go through varicose vein endovenous laser treatment and improve results.
Our Experience with Endovenous Laser Therapy for Varicose Veins
LASER THERAPY, 2010
Varicose veins of the lower limbs is one of the diseases of civilization marked by high morbidity and low mortality. 1) The conventional treatment of leg varices is surgery. Both the patient and the surgeon have similar expectations in terms of the outcome of varicose vein surgery: the removal of varices, and minimal scar tissue, guaranteed permanent effect and the avoidance of possible reccurrence. Thus offering a safe surgical intervention. Furthermore, the surgeon requires the surgery to be technically easy, non-traumatic and time efficient. The evolution of the surgical treatment of varicose veins of the lower limbs began with a radical crossectomy with great saphenous vein (GSV) stripping. This was followed by crossectomy with invaginated stripping and phlebectomy of the varicose branches later advancing into minimally invasive surgery. 2) One of the current modern treatments of varicose veins is the use of laser for endovenous occlusion of veins, a minimal invasive method of occlusion first carried out with the 819 nm laser. 3)
Minimally invasive techniques in the treatment of saphenous varicose veins
Journal of the American Academy of Dermatology, 2009
Lower extremity venous insufficiency is common and increases with age. In addition to classical symptoms, it may result in skin changes and venous ulcers. Chronic venous insufficiency has a great impact on patients' health-related quality of life and is associated with considerable health care costs. Surgical ligation of the junction with or without stripping has been the standard of care in the treatment of insufficient great and small saphenous veins. However, the recurrence rates are relatively high and surgery may be associated with serious adverse events and considerable down time; it is also cosmetically suboptimal. To improve efficacy, patients' health-related quality of life and treatment satisfaction and to reduce serious side effects, costs, and postoperative pain, several minimally invasive techniques have been introduced in the last decade. Dermatologists have played an important role in the development of these new therapies of truncal varicose veins. Of the new therapies, ultrasound-guided foam sclerotherapy, endovenous laser therapy, and radiofrequency ablation are the most common and challenge surgery as the ''gold standard'' of care for patients with varicose veins. The objective of this review is to inform clinicians about these 3 therapeutic options for truncal varicose veins and to describe and compare the procedures, indications, efficacy, and safety profile. ( J Am