Secondary ablation of saphenous veins: The reasons and the ratios
| Autor: | Ugur Ozkan, Aykut Recep Aktaş |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology 030230 surgery Thigh Angioplasty Laser 03 medical and health sciences Small saphenous vein 0302 clinical medicine Recurrence Varicose veins medicine Humans Saphenous Vein Vein Aged Laser ablation business.industry Ultrasonography Doppler Endovenous laser treatment General Medicine Middle Aged Ablation Surgery medicine.anatomical_structure Venous Insufficiency Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Lower limbs venous ultrasonography Follow-Up Studies |
| Zdroj: | Phlebology: The Journal of Venous Disease. 31:141-144 |
| ISSN: | 1758-1125 0268-3555 |
| DOI: | 10.1177/0268355515581742 |
| Popis: | Objective To assess recurrence of saphenous veins and their tributaries following endovenous laser ablation (EVLA) and define primary or secondary ablation ratios as a result of misinterpretation, new incompetency formation, and re-canalization. Methods The EVLA procedure was applied for vein insufficiency to 50 symptomatic patients (range, 22–78 years; mean age 45 ± 14 years; gender, 18 [36%] men, and 32 [64%] women). Before and after the procedure, a total of 80 legs were prospectively evaluated for recanalization of the great and small saphenous vein, anterolateral, posteromedial, intersaphenous thigh, and the calf veins by Doppler ultrasonography. EVLA was performed on the saphenous veins along with their tributaries, and was defined as the primary ablation. EVLA and alcohol ablation after the first procedure was defined as the secondary ablation. We evaluated the veins according to re-canalization and secondary ablation, and also measured the primary and secondary ablation ratios. Results Seventy-three (97.0%) VSM and 39 (95.0%) VSP were treated with primary ablation and 2(3.0%) VSM and 2 (5.0%) VSP were treated with secondary ablation because of newly developed incompetency. In addition, 15 (71.0%) saphenous tributaries were treated with primary and 6 (29.0%) with secondary ablation. After primary or secondary ablation, 9 (12.0%) misinterpretation or new incompetency formation was found during a one-year follow-up. Seven (9.0%) VSM were re-canalized at the mean length of 46 ± 15 cm (range 32–65 cm) in one year. The laser energy in the re-canalized VSM was 78 ± 25 joules/cm (range 61–83) and all were retreated with laser or foam sclerotherapy. Conclusions VSM re-canalization and new vessel incompetency formation are reasons for secondary ablation, which is not a rare condition. Follow-up examinations and anatomical mapping are crucial for detecting new vessel formation or miss-interpretation after sclerotherapy or EVLA treatment. |
| Databáze: | OpenAIRE |
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