Entrar/Registro  
HOME SPANISH
 
Cirugía y Cirujanos
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirugía y Cirujanos >Year 2010, Issue 6


Gómez-Palacio VM, Águila-Márquez R
Minimally invasive venous surgery
Cir Cir 2010; 78 (6)

Language: Español
References: 53
Page: 500-507
PDF: 317.56 Kb.


Full text




ABSTRACT

Background: Varicose vein surgery of the lower extremities is accomplished by new noninvasive modalities. In this study we evaluated the safety, efficacy, and recuperation time of radiofrequency associated with miniphlebectomies and foam sclerotherapy to treat primary varicose veins of the lower extremities.
Methods: From November 6, 2006 to December 15, 2009, 204 legs in 102 patients with symptomatic primary varicose veins were treated by radiofrequency. There were 74 females and 28 males. Average age was 38 ± 6 years. Preoperatively, each patient had a duplex ultrasound to evaluate permeability, competency of the deep venous system, localization of the reflux areas and diameter of the saphenous veins. Postoperatively, a duplex ultrasound was done at 72 h and at 6 and 12 months.
Results: At 12 months, radiofrequency was effective in 98% of the patients. In two cases (1.98%) there were recurrent varicose veins. There were no systemic complications. In one case there was burn damage of the skin requiring surgical treatment, due to perforation of the vein by the catheter tip. The mean recovery time was 1.14 days.
Conclusions: Radiofrequency associated with miniphlebectomies and foam sclerotherapy represents a safe and effective option to treat primary variceal disease in the lower extremities with less postoperative recovery time.


Key words: Endovenous thermal ablation, endovenous closure, endovenous radiofrequency, varicose vein.


REFERENCIAS

  1. Callam MJ. Epidemiology of variose veins. Br J Surg 1994;81:167-173

  2. Dwerryhouse S, Davis B, Harradine K. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five year results of a randomized trial. J Vasc Surg 1999:29:589-592.

  3. Sharif MA, Soong CV. Endovenous laser treatment for long saphenous vein incompetence. Br J Surg 2006;93:831-835.

  4. Min RJ, Khilnani N. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol 2003;14:991-996.

  5. Morrison N. Saphenous ablation: what are the choices, laser or RF energy. Sem Vasc Surg 2005;18:15-18.

  6. Roth SM. Endovenous radiofrequency ablation of superficial and perforator veins. Surg Clin North Am 2007;87:1267-1284.

  7. Dietzek MA. Endovenous radiofrequency ablation for the treatment of varicose veins. Vascular 2007;15:255-261.

  8. Perrin M. Endoluminal treatment of lower limb varicose veins by radiofrequency and laser. Endovasc Today 2007;(suppl):22-24.

  9. Sybrandy JEM, Wittens CHA. Initial experiences in endovenous treatment of saphenous vein reflux. J Vasc Surg 2002;36:1207-1212.

  10. Lumsden AB, Peden EK. Clinical use of the new VNUS Clousure Fast radiofrequency catheter. Endovasc Today 2007;suppl:7-10.

  11. Hunchliffe RJ, Ubhi J, Beech A. A prospective randomized controlled trial of VNUS closure versus surgery for the treatment of recurrent long saphenous varicose veins. Eur J Vasc Endovasc Surg 2006;31:212-218.

  12. Zikorus AW, Mirizzi MS. Evaluation of setpoint temperature and pullback speed on vein adventitial temperature during endovenous radiofrequency energy delivery in an in-vitro model. Vasc Endovascular Surg 2004;38:167-174.

  13. Manfrini S, Gasbarro V, Danielsson G, Norgren L, Chandler JG, Lennox AF, et al. Endovenous management of saphenous vein reflux. Endovenous Reflux Management Study Group. J Vasc Surg 2000;32:42-49.

  14. Hingorani AP, Ascher E, Markevich N. Deep venous thrombosis after radiofrequency ablation of greater saphenous vein: a word of caution. J Vasc Surg 2004;40:500-504.

  15. Gale SS, Dosick SM, Seiwert AJ. Regarding “deep venous thrombosis after radiofrequency ablation of greater saphenous vein”. J Vasc Surg 2005;41:374-378.

  16. Kundu S, Lurie F, Hecknkamp J, Brunkwall J. Recommended reporting standards for endovenous ablation for the treatment of venous insufficiency: Joint Statement of the American Venous Forum and the Society of Interventional Radiology. J Vasc Surg 2007;46:582-589.

  17. Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the CEAP classification. Mayo Clin Proc 1996;71:338-345-352.

  18. Jacox A. Acute pain management: operative or medical procedures and trauma. Clinical Practice Guideline No. 1. Rockville, MD: Agency for Health Care Research and Quality; 1992. pp. 116-117.

  19. Jones L, Braithwaite BD. Neovascularization is the principal cause of varicose veins recurrence: results of a randomized trial of stripping the long vein. Eur J Vasc Endovasc Surg 1996;12:442-445.

  20. Fische R, Chandler JG. The unresolved problem of recurrent saphenofemoral reflux. J Amer Coll Surg 2002;195:80-94.

  21. Van Rij AM, Jiang P, Solomon C. Recurrence after varicose vein surgery: a prospective long term clinical study with duplex ultrasound scanning and air plethysmography. J Vasc Surg 2003;38:935-943.

  22. Kostas T, Ioannou CV, Touloupakis E. Reccurent varicose veins after surgery: a new appraisal of a common and complex problem in vascular surgery. Eur J Vasc Endovasc Surg 2004;27:275-282

  23. Fischer R, Linde N, Duff C. Late recurrent saphenofemoral junction reflux after ligation and stripping of the greater saphenous vein. J Vasc Surg 2001:34:236-240

  24. Harris EJ. Endovascular obliteration of saphenous vein reflux: a perspective. J Vasc Surg 2002;35:1292-1294.

  25. Pichot O, Sessa C, Chandler JG. Role of duplex imaging in endovenous obliteration for primary venous insufficiency. J Endovasc Ther 2000;7:451-459.

  26. Pichot O, Kabnick SL. Duplex ultrasound scan findings two years after great saphenous vein radiofrequency endovenous obliteration. J Vasc Surg 2004;189-195.

  27. Ruckley CV, Evans CJ, Allan PL. Chronic venous insufficiency: clinical and duplex correlations. The Edinburg Vein Study of Venous Disorders in the General Population. J Vasc Surg 2002;36:520-525.

  28. Weiss RA, Weiss MA. Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: 2 year follow-up. Dermatol Surg 2002;28:38-42.

  29. Merchant RF, DePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: a multicenter study. J Vasc Surg 2002;35:1190-1196.

  30. Merchant RF, Pichot O. Long term outcomes of endovenous radiofrequency obliteration of saphenopus reflux as a treatment for superficial venous insufficiency. J Vasc Surg 2005;42:502-509.

  31. Perala J, Rautio T, Biancari F. Radiofrequency endovenous obliteration versus stripping of the long saphenous vein in the management of primary varicose veins: 3 years outcome of a randomized study. Ann Vasc Surg 2005;19:1-14.

  32. Puggioni A, Kalra M. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg 2005;42:488-501.

  33. Merchant RF, Pichot O, Mayers KA. Four year follow-up on endovascular radiofrequency obliteration of great saphenous reflux. Dermatol Surg 2005;31:129-134.

  34. Lurie F, Creton D, Eklof B. Prospective randomized study of endovenous radiofrequency obliteration (CLOSURE) versus ligation and stripping in a selected population (EVOLVES Study). J Vasc Surg 2003;38:207-214.

  35. Lurie F, Creton D, Eklof B. Prospective study of endovenous radiofrequency obliteration (CLOSURE) versus ligation and stripping (EVOLVES): two year follow-up. Eur J Vasc Endovasc Surg 2005;29:67-73.

  36. Zierav UT, Lahi W. The endovenous RFITT treatment of varicose veins, a new method of interventional phlebology. Technique and results. Phebologia 2009;38:12-16.

  37. Luebke T, Gawenda M, Millward FS, Padberg F, Vedanthaam S. Metaanalysis of endovenous radiofrequency obliteration of the great saphenous vein in primary varicosis. J Endovasc Ther 2008;15:213-223.

  38. Harris EJ. Radiofrequency ablation of the long saphenous vein without high ligation and stripping for the primary varicose veins, pros-cons. Semin Vasc Surg 2002;15:34-38.

  39. Scavee V, Lescev O. Hook phlebectomy vs transilluminated powered phlebectomy for varicose vein surgery. Early results. Eur J Vasc Endovasc Surg 2003;25:473-475.

  40. Elias MS. Minimally invasive vein surgery. Mount Sinai J Med 2004;71:42-46.

  41. Frasier K, Giangolan G. Endovascular radiofrequency ablation: a novel treatment of venous insufficiency in Klippel-Trenaunay patients. J Vasc Surg 2008;47:1339-1345.

  42. van den Bos R, Arends L. Endovenous therapies of lower extremity varicosities: a meta-analysis. J Vasc Surg 2009;49:230-239.

  43. Sadick MS. Advances in the treatment of varicose veins: ambulatory phlebectomies, foam sclerotherapy, endovascular laser and radiofrequency closure. Dermatol Clin 2005;23:443-445.

  44. Bush R, Ramone-Maxwell C. Endovenous and surgical extirpation of lower extremity varicose veins. Semin Vasc Surg 2008;21:50-53.

  45. Keller WL. A new method of extirpating the internal saphenous and similar veins in varicose condition: a preliminary report. New York Med J 1905;82:385.

  46. Babcock WW. A new operation for the extirpation of varicose veins of the leg. New York Med J 1907;96:153.

  47. McAusland S. The modern treatment of varicose veins. Med Press Circ 1939;201:404-410.

  48. Sterling M, Shortell C. Endovascular treatment of varicose veins. Semin Vasc Surg 2006;19:109-115.

  49. Min RJ, Khilnani NM. Endovascular laser ablation of varicose veins. J Cardiovasc Surg 2005;46:395-405

  50. Ohinmaa R. Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: randomized controlled trial with comparison cost. J Vasc Surg 2002;35:958-965.

  51. Chandler JG, Pichot O. Treatment of primary venous insufficiency by endovenous saphenous vein obliteration. Vasc Surg 2000;34:201-214.

  52. Sybrandy JEM, Wittens CHA. Initial experiences in endovenous treatment of saphenous vein reflux. J Vasc Surg 2002;36:1207-1212.

  53. Enzler MA, van den Bos RR. A new gold standard for varicose vein treatment? Eur J Vasc Endovasc Surg 2010;39:97-98.






>Journals >Cirugía y Cirujanos >Year 2010, Issue 6
 

· Journal Index 
· Links 






       
Copyright 2019