Radiofrequency Ablation for Axial Reflux Associated with Foam Sclerotherapy for Varicosities in One-Step Approach: A Prospective Cohort Study Comprising Large Diameters Saphenous Veins
| Autor: | Cristina Ribeiro Riguetti-Pinto, Douglas Poschinger-Figueiredo, Monica Rochedo Mayall, Luís Cristóvão Porto, Carlos Eduardo Virgini-Magalhães, Leonardo Silveira de Castro, Cláudia Amorim, Cristiane Ferreira de Araujo Gomes, Felipe Borges Fagundes |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Radiofrequency ablation Endocrinology Diabetes and Metabolism medicine.medical_treatment varicose ulcer law.invention Varicose Veins saphenous vein law Sclerotherapy catheter ablation Occlusion Varicose veins Ambulatory Care medicine Humans Pharmacology (medical) Prospective Studies Prospective cohort study Ultrasonography Interventional Original Research business.industry Great saphenous vein Public Health Environmental and Occupational Health Reflux virus diseases Hematology General Medicine Middle Aged Combined Modality Therapy Vein occlusion Vascular Health and Risk Management Surgery Treatment Outcome quality of life Feasibility Studies Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Vascular Health and Risk Management |
| ISSN: | 1178-2048 |
| Popis: | Douglas Poschinger-Figueiredo,1 Carlos Eduardo Virgini-Magalhães,1,2 LuÃs Cristóvão Porto,3,4 Claudia Salvador Amorim,1 Cristiane Ferreira de Araujo Gomes,1 Cristina Ribeiro Riguetti-Pinto,1,2 Monica Rochedo Mayall,1 Leonardo Silveira de Castro,1 Felipe Borges Fagundes1 1Teaching and Health Care Unit of Vascular and Endovascular Surgeryâs Medical Staff, Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio De Janeiro, Brazil; 2Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil; 3Histocompatibility and Cryopreservation Laboratory (HLA), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil; 4Roberto Alcantara Gomes Biology Institute (IBRAG), Rio de Janeiro State University (UERJ), Rio de Janeiro, BrazilCorrespondence: Douglas Poschinger-FigueiredoTeaching and Health Care Unit of Vascular and Endovascular Surgeryâs Medical Staff, Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Boulevard Vinte e Oito de Setembro, N 77, 4th Floor, Vila Isabel, Rio De Janeiro, RJ, 20551â 030, BrazilTel +55 21 2686-8643Fax +55 21 2587-4010Email dpvasc@icloud.comObjective: This study assessed the outcomes and impact on the quality of life following one-step outpatient radiofrequency ablation (RFA) and ultrasound guided foam sclerotherapy (USGFS) for large reflux with varicosities in the great saphenous vein (GSV).Design: Prospective, single-centre, analytical cohort.Materials and Methods: Thirty symptomatic patients having reflux in the GSV and varicosities (CEAP C3 to C6) were treated with RFA and USGFS simultaneously, in a single-step procedure, from March 2016 to December 2016. They were followed up at 1 week, 6 months, 1 and 3 years. Clinical outcomes, changes in the Quality of Life (QOL) questionnaires SF-36â¢, VCSS and AVVQ, evolutive vein occlusion rates were assessed by duplex ultrasound, and ulcer closure was checked.Results: The sample was divided into two groups: (Group 1) GSV diameter ⥠13.0 mm (median 19.0 [14â 24]), 17 subjects, and (Group 2) GSV diameter ⤠12.9 mm (median 10.3 [10â 12]), 16 subjects. No major adverse event was observed, and the postoperative minor adverse event rates were similar between the two groups. A significant improvement was observed in VCSS and AVVQ from the preoperative levels to the sixth month and the third-year follow-up. Twelve of 13 ulcers had healed at 1 year and remained closed until 3 years. The entire sample had a significant increase in all short form 36 domains, except for mental health in the Group 2 (GSV ⥠13.0 mm). Overall first week occlusion rate for the whole sample was 90.9% and 69.7% at the 3-year follow-up. No difference in occlusion rate was observed between the two groups at any time.Conclusion: Exclusively outpatient combined techniques were safe and feasible in this study with no major adverse events, despite the large diameters of the GSV or ulcer presence. Within 3 years, both diameter groups showed equivalent improvement in all QOL parameters, satisfactory axial occlusion, and maintained ulcer closure.Keywords: saphenous vein, varicose veins, varicose ulcer, quality of life, catheter ablation, sclerotherapy |
| Databáze: | OpenAIRE |
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