Christos Karathanos, Konstantinos Spanos, Konstantinos Batzalexis, Athanasios Chaidoulis, Konstantinos Tzimas-Dakis, Georgios Volakakis, George Kouvelos, Miltiadis Matsagas, Athanasios D Giannoukas
{"title":"静脉腔内热消融治疗大隐静脉闭塞的中期疗效。","authors":"Christos Karathanos, Konstantinos Spanos, Konstantinos Batzalexis, Athanasios Chaidoulis, Konstantinos Tzimas-Dakis, Georgios Volakakis, George Kouvelos, Miltiadis Matsagas, Athanasios D Giannoukas","doi":"10.1177/02683555241272971","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the efficacy and safety of endovenous thermal ablation (EVTA) in treating large diameter, ≥12 mm, incompetent great saphenous vein (GSV) in comparison to smaller ones.</p><p><strong>Methods: </strong>A retrospective comparative study was undertaken including 196 patients (205 limbs) undergoing EVTA. According to maximum GSV diameter patients were divided into two groups (group A <12 mm, group B ≥12 mm). Primary outcome was anatomic success defined as absence of reflux of GSV. Secondary outcomes were complications, postoperative pain using the 10-cm Visual Analog Scale (VAS) and improvement of Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Quality-of-Life Questionnaire (CΙVIQ-20) scores assessed at 7- days, 1 month, 12 months and 24 months postoperatively.</p><p><strong>Results: </strong>118 patients with GSV diameter <12 mm (group A) and 87 with GSV diameter ≥12 mm (group B) were included. Patients' demographics, CEAP classification and length of ablated vein did not differ between the groups. Preoperative VCSS and VAS pain score were significant greater in group B (6.03 vs 6.94, <i>p</i> = .04 and 5.21 vs 5.77, <i>p</i> = .032, respectively). No differences in adverse events were observed post-operatively among groups. GSV occlusion rate at 1 month was 98.3% (SE 1.3%) in group A and 96.5 % (2.2%) in group B (<i>p</i> = .3), at 12 months 95.7% (SE 2%) and 94.2% (SE 2.8%) (<i>p</i> = .5), and at 24 months 94% (SE 2.4%) and 93.1% (SE 3%) (<i>p</i> = .4) respectively. Both groups experienced significant and similar improvement in their VCSSs and CIVIQ scores postoperatively. In a subgroup analysis among different EVTA and GSV >12 mm, 1470 nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) showed comparable results in terms of occlusion rates, complications, VCSS and CIVIQ scores.</p><p><strong>Conclusions: </strong>Endovenous thermal ablation techniques are efective and safe in the treatment of GSV incompetence regardless the diameter of the GSV. Both 1470 nm EVLA and RFA techniques performed similar outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555241272971"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endovenous thermal ablation mid-term outcomes for the treatment of large diameter incompetent great saphenous veins.\",\"authors\":\"Christos Karathanos, Konstantinos Spanos, Konstantinos Batzalexis, Athanasios Chaidoulis, Konstantinos Tzimas-Dakis, Georgios Volakakis, George Kouvelos, Miltiadis Matsagas, Athanasios D Giannoukas\",\"doi\":\"10.1177/02683555241272971\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The aim of this study was to assess the efficacy and safety of endovenous thermal ablation (EVTA) in treating large diameter, ≥12 mm, incompetent great saphenous vein (GSV) in comparison to smaller ones.</p><p><strong>Methods: </strong>A retrospective comparative study was undertaken including 196 patients (205 limbs) undergoing EVTA. According to maximum GSV diameter patients were divided into two groups (group A <12 mm, group B ≥12 mm). Primary outcome was anatomic success defined as absence of reflux of GSV. Secondary outcomes were complications, postoperative pain using the 10-cm Visual Analog Scale (VAS) and improvement of Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Quality-of-Life Questionnaire (CΙVIQ-20) scores assessed at 7- days, 1 month, 12 months and 24 months postoperatively.</p><p><strong>Results: </strong>118 patients with GSV diameter <12 mm (group A) and 87 with GSV diameter ≥12 mm (group B) were included. Patients' demographics, CEAP classification and length of ablated vein did not differ between the groups. Preoperative VCSS and VAS pain score were significant greater in group B (6.03 vs 6.94, <i>p</i> = .04 and 5.21 vs 5.77, <i>p</i> = .032, respectively). No differences in adverse events were observed post-operatively among groups. GSV occlusion rate at 1 month was 98.3% (SE 1.3%) in group A and 96.5 % (2.2%) in group B (<i>p</i> = .3), at 12 months 95.7% (SE 2%) and 94.2% (SE 2.8%) (<i>p</i> = .5), and at 24 months 94% (SE 2.4%) and 93.1% (SE 3%) (<i>p</i> = .4) respectively. Both groups experienced significant and similar improvement in their VCSSs and CIVIQ scores postoperatively. In a subgroup analysis among different EVTA and GSV >12 mm, 1470 nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) showed comparable results in terms of occlusion rates, complications, VCSS and CIVIQ scores.</p><p><strong>Conclusions: </strong>Endovenous thermal ablation techniques are efective and safe in the treatment of GSV incompetence regardless the diameter of the GSV. Both 1470 nm EVLA and RFA techniques performed similar outcomes.</p>\",\"PeriodicalId\":94350,\"journal\":{\"name\":\"Phlebology\",\"volume\":\" \",\"pages\":\"2683555241272971\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Phlebology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/02683555241272971\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Phlebology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/02683555241272971","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Endovenous thermal ablation mid-term outcomes for the treatment of large diameter incompetent great saphenous veins.
Introduction: The aim of this study was to assess the efficacy and safety of endovenous thermal ablation (EVTA) in treating large diameter, ≥12 mm, incompetent great saphenous vein (GSV) in comparison to smaller ones.
Methods: A retrospective comparative study was undertaken including 196 patients (205 limbs) undergoing EVTA. According to maximum GSV diameter patients were divided into two groups (group A <12 mm, group B ≥12 mm). Primary outcome was anatomic success defined as absence of reflux of GSV. Secondary outcomes were complications, postoperative pain using the 10-cm Visual Analog Scale (VAS) and improvement of Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Quality-of-Life Questionnaire (CΙVIQ-20) scores assessed at 7- days, 1 month, 12 months and 24 months postoperatively.
Results: 118 patients with GSV diameter <12 mm (group A) and 87 with GSV diameter ≥12 mm (group B) were included. Patients' demographics, CEAP classification and length of ablated vein did not differ between the groups. Preoperative VCSS and VAS pain score were significant greater in group B (6.03 vs 6.94, p = .04 and 5.21 vs 5.77, p = .032, respectively). No differences in adverse events were observed post-operatively among groups. GSV occlusion rate at 1 month was 98.3% (SE 1.3%) in group A and 96.5 % (2.2%) in group B (p = .3), at 12 months 95.7% (SE 2%) and 94.2% (SE 2.8%) (p = .5), and at 24 months 94% (SE 2.4%) and 93.1% (SE 3%) (p = .4) respectively. Both groups experienced significant and similar improvement in their VCSSs and CIVIQ scores postoperatively. In a subgroup analysis among different EVTA and GSV >12 mm, 1470 nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) showed comparable results in terms of occlusion rates, complications, VCSS and CIVIQ scores.
Conclusions: Endovenous thermal ablation techniques are efective and safe in the treatment of GSV incompetence regardless the diameter of the GSV. Both 1470 nm EVLA and RFA techniques performed similar outcomes.
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