Journal ArticleDOI
Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins.
TLDR
This randomized trial compared four treatments for varicose great saphenous veins (GSVs) and found that treatment with a single excision procedure was more effective than two or three of the other methods.Abstract:
Background: This randomized trial compared four treatments for varicose great saphenous veins (GSVs). Methods: Five hundred consecutive patients (580 legs) with GSV reflux were randomized to endovenous laser ablation (980 and 1470 nm, bare fibre), radiofrequency ablation, ultrasound-guided foam sclerotherapy or surgical stripping using tumescent local anaesthesia with light sedation. Miniphlebectomies were also performed. The patients were examined with duplex imaging before surgery, and after 3 days, 1 month and 1 year. Results: At 1 year, seven (5· 8p er cent), six (4·8 per cent), 20 (16·3 per cent) and four (4· 8p er cent) of the GSVs were patent and refluxing in the laser, radiofrequency, foam and stripping groups respectively (P < 0·001). One patient developed a pulmonary embolus after foam sclerotherapy and one a deep vein thrombosis after surgical stripping. No other major complications were recorded. The mean(s.d.) postintervention pain scores (scale 0‐10) were 2·58(2·41), 1·21(1·72), 1·60(2·04) and 2·25(2·23) respectively (P < 0·001). The median (range) time to return to normal function was 2 (0‐25), 1 (0‐30), 1 (0‐30) and 4 (0‐30) days respectively (P < 0·001). The time off work, corrected for weekends, was 3·6 (0‐46), 2·9 (0‐14), 2·9 (0‐33) and 4·3 (0‐42) days respectively (P < 0·001). Disease-specific quality-of-life and Short Form 36 (SF-36 ) scores had improved in all groups by 1-year follow-up. In the SF-36 domains bodily pain and physical functioning, the radiofrequency and foam groups performed better in the short term than the others. Conclusion: All treatments were efficacious. The technical failure rate was highest after foam sclerotherapy, but both radiofrequency ablation and foam were associated with a faster recovery and less postoperative pain than endovenous laser ablation and stripping.read more
Citations
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Journal ArticleDOI
Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).
TL;DR: In this article, the management of chronic venous disease is addressed in the Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS) and the ESCV guidelines are presented.
Journal ArticleDOI
Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence.
Andrew N. Nicolaides,C. Allegra,J. Bergan,Andrew W. Bradbury,M. Cairols,Patrick Carpentier,A Comerota,C. Delis,Bo Eklof,N. Fassiadis,Niki A. Georgiou,George Geroulakos,U. Hoffmann,G. Jantet,Arkadiusz Jawień,Stavros K. Kakkos,Evi Kalodiki,Nicos Labropoulos,P. Neglen,Peter J. Pappas,Hugo Partsch,Michel Perrin,Eberhard Rabe,A. A. Ramelet,M Vayssaira,E. Ioannidou,A Taft +26 more
TL;DR: A systematic approach has been developed with recommendations based upon cumulative evidence from the literature, which range from Level I and Grade A to Level III and Grade C, and includes meta-analysis Meta-analyses but there should be caution as to their possible abuse.
Journal ArticleDOI
Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices
TL;DR: The overall quality of the evidence was moderate due to the variations in the reporting of results, which limited meaningful meta-analyses for the majority of proposed outcome measures.
Journal ArticleDOI
European guidelines for sclerotherapy in chronic venous disorders
Eberhard Rabe,F. X. Breu,A. Cavezzi,P. D. Coleridge Smith,A. Frullini,J.-L. Gillet,J. J. Guex,C. Hamel-Desnos,P. Kern,B. Partsch,Albert-Adrien Ramelet,L. Tessari,F. Pannier +12 more
TL;DR: This guideline gives recommendations concerning indications, contraindications, side-effects, concentrations, volumes, technique and efficacy of liquid and foam sclerotherapy of varicose veins and venous malformations.
Journal ArticleDOI
Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose)
Nick Morrison,Kathleen Gibson,Scott McEnroe,Mitchel P. Goldman,Ted King,Robert Weiss,Daniel J. Cher,Andrew T. Jones +7 more
TL;DR: CAE was proven to be noninferior to RFA for the treatment of incompetent GSVs at month 3 after the procedure, and both treatment methods showed good safety profiles.
References
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Journal ArticleDOI
Revision of the CEAP classification for chronic venous disorders: Consensus statement
Bo Eklof,Robert B. Rutherford,John J. Bergan,Patrick Carpentier,Peter Gloviczki,Robert L. Kistner,Mark H. Meissner,Gregory L. Moneta,Kenneth A. Myers,Frank T. Padberg,Michel Perrin,C. Vaughan Ruckley,Philip Coleridge Smith,Thomas W. Wakefield +13 more
TL;DR: The CEAP classification for chronic venous disorders was developed in 1994 by an international ad hoc committee of the American Venous Forum, endorsed by the Society for Vascular Surgery, and incorporated into "Reporting Standards in Venous Disease" in 1995.
Journal ArticleDOI
Epidemiology of varicose veins
TL;DR: The data suggest that female sex, increased age, pregnancy, geographical site and race are risk factors for varicose veins: there is no hard evidence that family history or occupation are factors.
Journal ArticleDOI
Venous severity scoring: An adjunct to venous outcome assessment
Robert B. Rutherford,Frank T. Padberg,Anthony J. Comerota,Robert L. Kistner,Mark H. Meissner,Gregory L. Moneta +5 more
TL;DR: An American Venous Forum committee on venous outcomes assessment has developed a venous severity scoring system based on the best usable elements of the CEAP system, intended to complement the currentCEAP system.
Journal ArticleDOI
Endovenous therapies of lower extremity varicosities: a meta-analysis.
TL;DR: A systematic review of Medline, Cochrane Library, and Cinahl was performed to identify studies on the effectiveness of the four minimally invasive techniques up to February 2007 as discussed by the authors.
Journal ArticleDOI
Prospective randomized study of endovenous radiofrequency obliteration (closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study).
Fedor Lurie,Denis Creton,Bo Eklof,Lowell S. Kabnick,Robert L. Kistner,Olivier Pichot,S. Schuller-Petrovic,C. Sessa +7 more
TL;DR: In the absence of significant complications, such as deep vein thrombosis and pulmonary embolism, severe neuritic sequelae, and skin burns, there are significant early advantages to endovascular obliteration of the GSV compared with conventional vein stripping.