Clinical outcomes of nonthermal ablation, thermal ablation, and surgical stripping for varicose veins

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders Pub Date : 2024-05-15 DOI:10.1016/j.jvsv.2024.101902

{"title":"Clinical outcomes of nonthermal ablation, thermal ablation, and surgical stripping for varicose veins","authors":"","doi":"10.1016/j.jvsv.2024.101902","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare the clinical outcomes of radiofrequency ablation (RFA), cyanoacrylate closure (CAC), mechanochemical ablation (MOCA), and surgical stripping (SS) for incompetent saphenous veins and to determine a suitable treatment modality for a specific clinical situation.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the data of patients with varicose veins who underwent RFA, CAC, MOCA, or SS from January 2012 to June 2023. The clinical outcomes, including postoperative complications and the Aberdeen Varicose Vein Questionnaire score, were assessed.</div></div><div><h3>Results</h3><div>During the study period, 2866 patients with varicose veins were treated. Among them, 1670 patients (57.9%) were women. The mean age was 55.3 ± 12.9 years. RFA, CAC, MOCA, and SS were performed in 1984 (68.7%), 732 (25.4%), 78 (2.7%), and 88 (3.0%) patients, respectively. The complete target vein closure rate after RFA, CAC, and MOCA was 94.5%, 98%, and 98%, respectively. The absence of a target vein after SS was 98%. Deep vein thrombosis developed in four patients: one in the RFA group and three in CAC group. Surgical or endovenous procedure-induced thrombosis occurred in 2.3%, 4.8%, 6.4%, and 2.3% of the patients after RFA, CAC, MOCA, and SS, respectively. Phlebitis along the target vein occurred in 0.2% and 3.8% of patients after RFA and MOCA, respectively. A hypersensitivity reaction occurred in 3.7% of patients after CAC. Readmission was required for two patients who had undergone SS. Transient nerve symptoms developed in five (0.3%), zero, one (1.3%), and two (2.3%) patients after RFA, CAC, MOCA, and SS, respectively. After treatment, the Aberdeen Varicose Vein Questionnaire score improved significantly in all groups.</div></div><div><h3>Conclusions</h3><div>The clinical outcomes with improvement in quality of life were comparable among the different treatment modalities. The proximity of the nerve or skin to the target vein is the most important factor in selecting a suitable treatment modality.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"12 6","pages":"Article 101902"},"PeriodicalIF":2.8000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of vascular surgery. Venous and lymphatic disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213333X24002208","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

The purpose of this study was to compare the clinical outcomes of radiofrequency ablation (RFA), cyanoacrylate closure (CAC), mechanochemical ablation (MOCA), and surgical stripping (SS) for incompetent saphenous veins and to determine a suitable treatment modality for a specific clinical situation.

Methods

We retrospectively reviewed the data of patients with varicose veins who underwent RFA, CAC, MOCA, or SS from January 2012 to June 2023. The clinical outcomes, including postoperative complications and the Aberdeen Varicose Vein Questionnaire score, were assessed.

Results

During the study period, 2866 patients with varicose veins were treated. Among them, 1670 patients (57.9%) were women. The mean age was 55.3 ± 12.9 years. RFA, CAC, MOCA, and SS were performed in 1984 (68.7%), 732 (25.4%), 78 (2.7%), and 88 (3.0%) patients, respectively. The complete target vein closure rate after RFA, CAC, and MOCA was 94.5%, 98%, and 98%, respectively. The absence of a target vein after SS was 98%. Deep vein thrombosis developed in four patients: one in the RFA group and three in CAC group. Surgical or endovenous procedure-induced thrombosis occurred in 2.3%, 4.8%, 6.4%, and 2.3% of the patients after RFA, CAC, MOCA, and SS, respectively. Phlebitis along the target vein occurred in 0.2% and 3.8% of patients after RFA and MOCA, respectively. A hypersensitivity reaction occurred in 3.7% of patients after CAC. Readmission was required for two patients who had undergone SS. Transient nerve symptoms developed in five (0.3%), zero, one (1.3%), and two (2.3%) patients after RFA, CAC, MOCA, and SS, respectively. After treatment, the Aberdeen Varicose Vein Questionnaire score improved significantly in all groups.

Conclusions

The clinical outcomes with improvement in quality of life were comparable among the different treatment modalities. The proximity of the nerve or skin to the target vein is the most important factor in selecting a suitable treatment modality.

查看原文本刊更多论文

非热消融、热消融和手术剥脱治疗静脉曲张的临床效果。

研究目的本研究旨在比较射频消融术（RFA）、氰基丙烯酸酯闭合术（CAC）、机械化学消融术（MOCA）和手术剥脱术（SS）治疗无功能隐静脉的临床效果，以确定在特定临床情况下适合的治疗方式：我们回顾性研究了 2012 年 1 月至 2023 年 6 月期间接受 RFA、CAC、MOCA 或 SS 治疗的静脉曲张患者的数据。评估了临床结果，包括术后并发症和阿伯丁静脉曲张问卷（AVVQ）评分：研究期间，共有 2866 名静脉曲张患者接受了治疗。其中，1670 名患者（57.9%）为女性。平均年龄为（55.3±12.9）岁。分别有 1,984 例（68.7%）、732 例（25.4%）、78 例（2.7%）和 88 例（3.0%）患者接受了 RFA、CAC、MOCA 和 SS 治疗。RFA、CAC和MOCA术后靶静脉完全闭合率分别为94.5%、98%和98%。SS术后没有靶静脉的比例为98%。4 名患者发生了深静脉血栓，其中 RFA 组 1 人，CAC 组 3 人。RFA、CAC、MOCA和SS术后分别有2.3%、4.8%、6.4%和2.3%的患者发生了手术或静脉内手术诱发的血栓形成。RFA和MOCA术后分别有0.2%和3.8%的患者发生了靶静脉静脉炎。3.7% 的患者在接受 CAC 后出现过敏反应。两名接受过 SS 手术的患者需要再次入院。接受 RFA、CAC、MOCA 和 SS 治疗后，分别有 5 例（0.3%）、0 例、1 例（1.3%）和 2 例（2.3%）患者出现一过性神经症状。治疗后，各组患者的 AVVQ 评分均有明显改善：结论：不同治疗方法的临床效果和生活质量改善程度相当。神经或皮肤与靶静脉的距离是选择合适治疗方式的最重要因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of vascular surgery. Venous and lymphatic disorders SURGERYPERIPHERAL VASCULAR DISEASE&n-PERIPHERAL VASCULAR DISEASE

CiteScore

6.30

自引率

18.80%

发文量

328

审稿时长

71 days

期刊介绍： Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.