A longitudinal single-center cohort study on the prevalence and risk of accessory saphenous vein reflux after radiofrequency segmental thermal ablation of great saphenous veins
| Autor: | Thomas Möhler, Thomas M. Proebstle |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty animal structures Adolescent medicine.medical_treatment Femoral vein Catheter ablation Anterior accessory saphenous vein Veins Cohort Studies Varicose Veins Young Adult Varicose veins Occlusion Prevalence medicine Humans Saphenous Vein Longitudinal Studies Prospective Studies Prospective cohort study Aged Leg business.industry Hemodynamics Reflux Femoral Vein Middle Aged Ablation Surgery Treatment Outcome medicine.anatomical_structure Venous Insufficiency embryonic structures Catheter Ablation Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular Surgery: Venous and Lymphatic Disorders. 3:265-269 |
| ISSN: | 2213-333X |
| DOI: | 10.1016/j.jvsv.2014.10.001 |
| Popis: | Objective Endothermal ablation has become a commonly used technology for occlusion of refluxing great saphenous veins (GSVs). However, the risk for primarily untreated accessory saphenous veins (ASVs) to develop reflux during follow-up has not yet been defined. Here, the prevalence and risk of ASV reflux is explored. Methods During a prospective multicenter cohort study on radiofrequency segmental thermal ablation of refluxing GSVs, the presence and reflux status of ASVs were monitored in 93 legs in a single center. Control examinations were performed after 1 week and at 12, 24, 36, and 48 months. Life-table and multiple regression analyses were used to describe frequency and risk factors for presence of reflux in untreated ASVs. Results Of 93 legs, 82 (88%) were available for 4-year follow-up. At baseline, 43 legs (46%) had an anterior ASV detectable by duplex ultrasound, with only two legs (2%) presenting with reflux. During 4 years of follow-up, according to life-table analysis, the proportion of legs with a detectable anterior ASV increased to 71% (n = 65); 32% of all legs and 55% of legs with a detectable anterior ASV exhibited refluxing anterior ASVs. Remarkably, in 35% of all legs with an anterior ASV, this reflux presented as a source of axial reflux, suggesting hemodynamic relevance. Posterior ASVs were detected in only 10 legs during 4-year follow-up, exhibiting reflux in only two cases. Conclusions Whereas posterior ASVs were meaningless, refluxing anterior ASVs occurred in a significant proportion of legs after thermal ablation of GSVs. Whether nonrefluxing anterior ASVs should be treated at the time of GSV ablation needs further examination. |
| Databáze: | OpenAIRE |
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