International Angiology最新文献

{"title":"Saphenous vein versus synthetic graft in arteriovenous fistula for hemodialysis in patient with inaccessible veins.","authors":"Ali M Galal, Mohamed A Ismail, Marco S Abdrabo, Ahmed K Mahmoud","doi":"10.23736/S0392-9590.24.05287-8","DOIUrl":"10.23736/S0392-9590.24.05287-8","url":null,"abstract":"<p><strong>Background: </strong>An autologous arteriovenous fistula (AVF) provides an optimal and secure way for managing the condition. An optimal blood supply to hemodialysis is linked to decreased incidence of complications and mortality, as well as reduced expenses. The objective of this research was to evaluate the outcome of people with suboptimal superficial venous system quality or who had exhausted all available arteriovenous fistula options, who received either autologous saphenous vein graft or polytetrafluoroethylene (PTFE) interposition graft as an access for effective hemodialysis.</p><p><strong>Methods: </strong>This prospective randomized controlled trail was carried out on fifty cases with chronic renal failure on hemodialysis and inaccessible superficial veins of both upper limbs for AVF. Cases were separated into two equal groups: Group A: cases performed saphenous vein reposition graft for hemodialysis access. Group B: cases who underwent PTFE interposition graft for prosthetic hemodialysis access.</p><p><strong>Results: </strong>Time for maturation and time for graft maturation, operative time, hospital stay, and postoperative HB were significant increase in group A in contrast to group B (P<0.05). Blood loss was significant decrease in group A in contrast to group B (P<0.001).</p><p><strong>Conclusions: </strong>Patients underwent saphenous vein repositioning graft for hemodialysis access required prolonged operative time and hospital stay. Cases that underwent PTFE interposition graft for prosthetic hemodialysis access were less in time for maturation and time for graft maturation.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"615-620"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycocalyx disruption, endothelial dysfunction and vascular remodeling as underlying mechanisms and treatment targets of chronic venous disease.","authors":"Jose A Diaz, Sergio Gianesini, Raouf A Khalil","doi":"10.23736/S0392-9590.24.05339-2","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05339-2","url":null,"abstract":"<p><p>The glycocalyx is an essential structural and functional component of endothelial cells. Extensive hemodynamic changes cause endothelial glycocalyx disruption and vascular dysfunction, leading to multiple arterial and venous disorders. Chronic venous disease (CVD) is a common disorder of the lower extremities with major health and socio-economic implications, but complex pathophysiology. Genetic aberrations accentuated by environmental factors, behavioral tendencies, and hormonal disturbances promote venous reflux, valve incompetence, and venous blood stasis. Increased venous hydrostatic pressure and changes in shear-stress cause glycocalyx injury, endothelial dysfunction, secretion of adhesion molecules, leukocyte recruitment/activation, and release of cytokines, chemokines, and hypoxia-inducible factor, causing smooth muscle cell switch from contractile to synthetic proliferative phenotype, imbalance in matrix metalloproteinases (MMPs), degradation of collagen and elastin, and venous tissue remodeling, leading to venous dilation and varicose veins. In the advanced stages of CVD, leukocyte infiltration of the vein wall causes progressive inflammation, fibrosis, disruption of junctional proteins, accumulation of tissue metabolites and reactive oxygen and nitrogen species, and iron deposition, leading to skin changes and venous leg ulcer (VLU). CVD management includes compression stockings, venotonics, and surgical intervention. In addition to its antithrombotic and fibrinolytic properties, literature suggests sulodexide benefits in reducing inflammation, promoting VLU healing, improving endothelial function, exhibiting venotonic properties, and inhibiting MMP-9. Understanding the role of glycocalyx, endothelial dysfunction, and vascular remodeling should help delineate the underlying mechanisms and develop improved biomarkers and targeted therapy for CVD and VLU.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"563-590"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of single peroneal versus single non-peroneal tibial angioplasty in limb salvage.","authors":"Amr A Mahmoud, Emad E Hussein, Assem M Herzallah, Mohamed A Elbahat","doi":"10.23736/S0392-9590.24.05305-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05305-7","url":null,"abstract":"<p><strong>Background: </strong>The peroneal artery is known to give branches to the anterior and posterior tibial arteries. Scattered reports in the literature over the last decade failed to provide solid evidence as to the optimum strategy for below-knee targeted revascularization in limited-option patients with critical limb-treating ischemia (CLTI). We sought to determine the benefit of performing single peroneal tibial artery angioplasty revascularization compared with single non-peroneal angiosome-targeted tibial artery angioplasty revascularization for patients presented with CLTI.</p><p><strong>Methods: </strong>We performed a two-center, retrospective cohort study of patients presented with CLTI treated with below-the-knee endovascular intervention from January 2020 to January 2022. Group 1 included patients who were treated with single peroneal tibial artery angioplasty revascularization. Group 2 included patients who were treated with single non-peroneal tibial artery angioplasty revascularization. Patients had no proximal lesions or previous intervention to tibial arteries. The primary endpoint is limb salvage. The secondary endpoints include wound healing and all-cause mortality.</p><p><strong>Results: </strong>This study included 45 patients presented with critical limb ischemia, they were treated with single angiosome-targeted tibial angioplasty revascularization, they were divided into 13 patients (28.9%) with single peroneal revascularization (group 1) and 32 patients (71.1%) with single non-peroneal revascularization (group 2), 20 patients (44.4%) had target anterior tibial artery, while 12 patients (26.7%) had target posterior tibial artery. The follow-up duration was 6 months. No difference was found in limb salvage between the two groups (92.3% vs. 87.1%; P=1). No differences were found in wound healing rates between the two groups (76.9% vs. 81.3%; P=0.281). The overall 30-day survival rate was 100% in both study groups.</p><p><strong>Conclusions: </strong>Single peroneal tibial revascularization mostly is non-inferior to single non-peroneal angiosome targeted tibial artery revascularization regarding limb salvage and wound healing for patients with critical limb ischemia.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"606-614"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rheolytic thrombectomy AngioJet™ is a safe and technically feasible method for treating acute and sub-acute occluding lesions in the visceral arteries.","authors":"Bachar Al Haj, Imam T Ritonga, Martin J Austermann, Marco V Usai","doi":"10.23736/S0392-9590.24.05326-4","DOIUrl":"10.23736/S0392-9590.24.05326-4","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to evaluate the safety and feasibility of the AngioJet™ device in the endovascular treatment of visceral ischemia with stenotic or occlusive lesions.</p><p><strong>Methods: </strong>Retrospective analysis of patients treated for visceral artery occlusion with thrombectomy using the AngioJet™ (Boston Scientific, MA, USA). Inclusion criteria: patients with stenotic or occluding lesion in visceral arteries including renal and mesenteric arteries, who received endovascular treatment with AngioJet™.</p><p><strong>Results: </strong>Eighteen patients with acute and sub-acute visceral arteries occlusions underwent endovascular thrombectomy. In twelve cases the procedure was successful, and the patients were discharged with patent target arteries. Four cases required re-intervention and two cases ended with a fatal complication. The technical and clinical success rate in our study was 88,9% (sixteen out of eighteen), these patients were discharged from hospital with patent target arteries.</p><p><strong>Conclusions: </strong>The thrombectomy using the AngioJet™ device is an effective and feasible method for the treatment of stenotic or occluding lesions of the visceral arteries with rapid post-interventional clinical improvement and minimal adverse events.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"591-596"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm results after FEVAR and open surgery for infrarenal aortic aneurysms with short proximal necks: systematic review with meta-analysis of comparative studies.","authors":"Diana Lopes, José Oliveira-Pinto, Armando Mansilha","doi":"10.23736/S0392-9590.24.05283-0","DOIUrl":"10.23736/S0392-9590.24.05283-0","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review with meta-analysis aimed to compare short and midterm outcomes between fenestrated endovascular aneurysm repair and open surgery in repair of infrarenal abdominal aortic aneurysms with short necks.</p><p><strong>Evidence acquisition: </strong>PubMed, Web of Science and Scopus electronic databases were searched for studies referring to fenestrated endovascular aneurysm repair (FEVAR) or open surgery (OSR) in patients with infrarenal abdominal aortic aneurysms with neck length <15 mm. The primary endpoint of interest was early mortality. Secondary outcomes included major adverse cardiovascular events (MACE), bowel ischemia, acute kidney injury (AKI), late mortality and secondary interventions.</p><p><strong>Evidence synthesis: </strong>Overall, 21 studies were included, with a total of 3084 patients (1157 FEVAR and 1927 OSR). The pooled rate of early mortality following FEVAR was 2.7% (95%CI: 1.6, 4.0; I²=27.7%), compared with 3.7% (95%CI: 1.9, 6.0; I²=78.1%) after OSR. Comparative studies demonstrated no significant differences in 30-day mortality (odds ratio [OR] 0.79; 95%CI: 0.37, 1.68). A decreased risk of postoperative MACE (OR=0.51; 95%CI: 0.28, 0.95) and bowel ischemia (OR=0.30; 95%CI: 0.11, 0.86) was observed in FEVAR patients although no significant differences were seen regarding AKI (OR=0.62; 95%CI: 0.23, 1.67). Late mortality (OR=1.68; 95%CI: 1.03, 2.74) and reintervention risk (OR=4.17; 95%CI: 2.05, 8.50) were both significantly higher in FEVAR group.</p><p><strong>Conclusions: </strong>FEVAR and OSR showed no statistically significant differences in postoperative mortality in the treatment of patients with AAA with short neck length, despite lower morbidity in the former. Oppositely, FEVAR present with greater mortality and reintervention risk in the midterm. Randomized controlled trials are needed to provide secure recommendations towards preferential use of either technique for juxtarenal AAA repair.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"597-605"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of intraoperative Fogarty balloon dilation on arteriovenous fistula success: clinical and functional outcomes.","authors":"Güler G Ersoy, Burak Tamtekin, İsmail Taskent","doi":"10.23736/S0392-9590.24.05351-3","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05351-3","url":null,"abstract":"<p><strong>Background: </strong>An effectively functioning arteriovenous fistula (AVF) is vital for end-stage renal disease patients. This study aims to evaluate the effects of Fogarty^® balloon catheter dilation on creating an effectively functioning AVF.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at our clinic between 2020 and 2022. A total of 120 patients underwent arteriovenous fistula (AVF) creation with intraoperative Fogarty^® balloon catheter dilation. Inclusion criteria required the presence of a palpable radial artery and superficial vein in the non-dominant arm, which was confirmed via Doppler ultrasound when necessary. The surgical approach involved side-to-side anastomosis between the radial artery and cephalic vein, followed by intraoperative dilation of the artery, vein, and anastomotic area using a Fogarty^® balloon catheter after completion of the anastomosis.</p><p><strong>Results: </strong>The study included 120 patients aged between 26 and 89 years, with a nearly equal gender distribution (57 females, 47.5%; and 63 males, 52.5%). The success rate of arteriovenous fistulas (AVFs) was evaluated according to the number of patients who were able to start adequate hemodialysis 6 weeks after surgery. At 6-week follow-up, 114 patients successfully started hemodialysis through these AVFs. In contrast, six patients could not obtain an adequate AVF for effective hemodialysis. As a result, the overall success rate was calculated as 95%.</p><p><strong>Conclusions: </strong>This study suggests that intraoperative Fogarty balloon dilatation may contribute positively to the success rate of AVF creation. The findings indicate that this technique could be considered as a potential intraoperative strategy to optimize AVF outcomes, especially in patients with challenging vascular anatomy or a history of AVF failure.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"629-635"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral rivaroxaban for the treatment of deep vein thrombosis in outpatients: a propensity score-matched comparison with a historical inpatient population.","authors":"Ilya V Schastlivtsev, Kirill V Lobastov, Emel Dubar, Athena V Matveeva, Anna V Kovalchuk, Sergey N Tsaplin, Leonid A Laberko","doi":"10.23736/S0392-9590.24.05352-5","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05352-5","url":null,"abstract":"<p><strong>Background: </strong>Despite the guidelines' appeal to treat patients with deep vein thrombosis and low-risk pulmonary embolism in outpatient settings, the real-world evidence shows a high prevalence of inpatient therapy leading to unwarranted health resource utilization. The study aimed to assess the efficacy and safety of rivaroxaban in outpatient settings compared to inpatient treatment.</p><p><strong>Methods: </strong>A propensity score-matched comparison with a historical inpatient population was performed based on a retrospective analysis of patients with deep vein thrombosis and without pulmonary embolism treated as outpatients with oral rivaroxaban. Inpatient controls were treated with oral rivaroxaban following a short-term initial therapy with low-molecular-weight heparins. The relevant outcomes extracted from electronic medical records were as follows: recurrent deep vein thrombosis and symptomatic pulmonary embolism, major bleeding, clinically relevant non-major bleeding, minor bleeding, unscheduled hospitalization, and death.</p><p><strong>Results: </strong>Among 209 outpatients who were never admitted to the hospital the deep vein thrombosis recurrence rate was 3.3% (95%CI, 1.6-6.8%), clinically relevant non-major bleeding rate 2.9% (95%CI, 1.3-6.1), minor bleeding rate 6.2% (95%CI, 3.7-10.0%), unscheduled hospitalization rate 1.4% (95%CI, 0.5- 4.1%), mortality rate 1.4% (95%CI, 0.5-4.1%). No symptomatic pulmonary embolism or major bleeding was detected. No statistically significant differences were observed when compared with inpatient controls.</p><p><strong>Conclusions: </strong>The outpatient use of rivaroxaban for deep vein thrombosis treatment is a safe and effective approach for patients without pulmonary embolism, with no significant differences when compared to inpatient therapy with oral rivaroxaban following a short-term initial therapy with low-molecular-weight heparins.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"553-562"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and percutaneous transluminal angioplasty treatment outcomes of superior vena cava obstruction in patients undergoing hemodialysis.","authors":"Ran Tian, Zhengli Tan, Zhengya Yu","doi":"10.23736/S0392-9590.24.05347-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05347-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the clinical outcomes of percutaneous transluminal angioplasty (PTA) in patients undergoing hemodialysis with different types of superior vena cava obstruction (SVCO) lesions.</p><p><strong>Methods: </strong>This retrospective observational study recruited patients undergoing hemodialysis with SVCO and analyzed the clinical characteristics of SVCO. Patency rates were collected for patients treated with PTA and were assessed using the t-test, U-test, log-rank test and survival analyses such as the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 49 patients undergoing hemodialysis with SVCO were classified as type I (N.=17), type II (N.=7), type III (N.=15) and type IV (N.=10). All patients had a history of catheter placement. There were 14 cases of SVCO-related catheter dysfunction, and PTA was performed in 35 patients with a technical success rate of 77.14% (27/35). Failures were observed exclusively in eight patients with type III or IV lesions. The median follow-up was 15 (1.5-58) months, with 6- and 12-month post-PTA primary patency rates of 51.9% and 14.4%, respectively. The primary assisted patency rates were 70.2% and 55.2%, and the secondary patency rates were 92.6% and 78.0%, requiring 2.68 PTAs per patient per year to maintain them. Type I-II lesions demonstrated significantly higher primary patency and primary assisted patency rates than type III-IV lesions (P=0.007 and P=0.002).</p><p><strong>Conclusions: </strong>Percutaneous transluminal angioplasty may be used to treat type I or II SVCO, achieving high technical success and patency rates. Patients undergoing hemodialysis with SVCO may have a condition related more to catheter placement than to arteriovenous fistula.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"43 6","pages":"621-628"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of arterial hypertension in patients with peripheral arterial disease.","authors":"Pavel Poredoš, Dimitri P Mikhailidis, Kosmas I Paraskevas, Aleš Blinc, Pier L Antignani, Agata Stanek, Armando Mansilha, Matija Cevc","doi":"10.23736/S0392-9590.24.05242-8","DOIUrl":"10.23736/S0392-9590.24.05242-8","url":null,"abstract":"<p><p>Hypertension is a major risk factor for peripheral arterial atherosclerotic disease (PAD). Hypertension deteriorates arterial wall function and the morphology of all layers of arteries. Endothelial cell injury enhances permeability and promotes migration of cholesterol and monocytes into the vessel wall. Increased blood pressure (BP) through hyperplasia of smooth muscle cells initiates remodeling of the arterial wall that increases peripheral resistance. Further, hypertension, particularly in patients with dyslipidemia, provokes atherosclerosis in different vascular territories, including the lower legs. Guidelines recommend treatment of hypertension in patients with PAD to reach the target BP of <130/80 mmHg. However, systolic BP (SBP) <120 mmHg may worsen oxygen delivery to the diseased leg and is related to a higher rate of cardiovascular (CV) events. Therefore, there is a J-shape relationship between SBP and the rate of primary outcomes. Any class of antihypertensive drugs, including beta-blockers, can be used for the treatment of hypertension in patients with PAD. Angiotensin converting enzyme (ACE) inhibitors may have some additional benefit over other antihypertensive drugs including improvement of perfusion of the diseased leg and are recommended even in patients with critical limb ischemia. In conclusion: hypertensive patients with PAD are at increased risk for CV events and treatment of raised BP is indicated, but SBP <120 mmHg and DBP <70 mmHg may contribute to adverse limb outcomes and other CV events. Consequently, PAD patients may require a different BP target than those without PAD.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"541-547"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for the treatment of recurrent varicose vein disease arising from the saphenofemoral junction or the great saphenous vein: a systematic review and meta-analysis.","authors":"Alkis Bontinis, Vangelis Bontinis, Georgios Koudounas, Argirios Giannopoulos, Christos Karkos, Dimitrios Virvilis, Angeliki Chorti, Kiriakos Ktenidis","doi":"10.23736/S0392-9590.24.05323-9","DOIUrl":"10.23736/S0392-9590.24.05323-9","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the safety and feasibility of the available interventions in the treatment of recurrent varicose vein disease.</p><p><strong>Evidence acquisition: </strong>A systematic search on Medline, Scopus, and Web of Science for articles published by August 2024 was performed. Primary endpoints included duplex ultrasonography (DUS)-identified recurrence and clinical recurrence.</p><p><strong>Evidence synthesis: </strong>Twenty-eight studies, eleven describing endovenous thermal ablation (EVTA), four ultrasound-guided foam sclerotherapy (UGFS), and thirteen surgery (high ligation with or without stripping) encompassing 2228 limbs, were included. The overall DUS-detected recurrence estimate was 11.84% (95% CI: 7.15-17.40). EVTA displayed the lowest recurrence of 4.27% (95% CI: 0.37-10.75), followed by UGFS 11.19% (95% CI: 6.80-16.42) and surgery 23.27% (95% CI: 15.35-32.19). Statistically significant differences were observed between surgery and both EVTA (P<0.01) and UGFS (P=0.01). The overall clinical recurrence estimate was 24.91% (95% CI: 10.40-42.96) with EVTA portraying the lowest clinical recurrence of 2.37% (95% CI: 0.00-16.81), followed by surgery 31.08% (95% CI: 14.43-50.63). Subgroup analysis identified statistically significant differences between EVTA and surgery (P=0.01). Whereas non-statistically significant differences were identified between the included interventions regarding paresthesia and deep vein thrombosis (DVT), surgery exhibited higher wound infection estimates compared to EVTA of 0.00% (95% CI: 0.00-0.80) versus 4.34% (95% CI: 2.21-7.02, P<0.01). The pooled hematoma and lymphatic complication estimates for surgery were 5.04% (95% CI: 0.50-12.87) and 5.71% (95% CI: 2.91-9.22) respectively.</p><p><strong>Conclusions: </strong>This review demonstrated the superior efficacy of EVTA over surgery in treating recurrent varicose vein disease corroborating its use as the preferred treatment, when feasible. Additionally, UGFS displayed comparable outcomes to EVTA. The notable recurrence estimates associated with surgery call into question its suitability within this context.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"485-496"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}