Flávia Lins Bezerra de Souza Fonseca, Esdras Marques Lins, Emmanuelle Tenório Albuquerque Godoi, Henrique Jorge Guedes, Ana Júlia Xavier de Mendoza, Camila Beatriz Serrano de Oliveira
{"title":"热消融术后大隐静脉支流的形态功能评估：病例系列。","authors":"Flávia Lins Bezerra de Souza Fonseca, Esdras Marques Lins, Emmanuelle Tenório Albuquerque Godoi, Henrique Jorge Guedes, Ana Júlia Xavier de Mendoza, Camila Beatriz Serrano de Oliveira","doi":"10.1016/j.jvsv.2024.101986","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates hemodynamic and anatomic changes in great saphenous vein (GSV) tributaries after endovenous laser ablation (EVLA).</p><p><strong>Methods: </strong>This case series analyzed 112 areas in 28 lower limbs of 25 patients who underwent EVLA from April 2022 to June 2023 at the Hospital das Clínicas de Pernambuco/UFPE. All patients were evaluated by Doppler ultrasound preoperatively and 3 months after the surgical treatment. The parameters studied were GSV diameter and patency, GSV tributary diameter, patency and flow direction, and the Venous Clinical Severity Score after EVLA. The GSV characteristics were evaluated in four regions: saphenous-femoral junction, medium thigh, knee, and medium leg. The tributary veins were grouped in four areas: anterior thigh, posterior thigh, anterior leg, and posterior leg.</p><p><strong>Results: </strong>The results included 28 lower limbs from 23 patients; 18 patients (67.9%) were women, and the average age was 49 years; 2 patients were lost to follow-up. Ninety days after EVLA, all treated GSVs were occluded. The average diameter of GSV decreased in all four regions studied: saphenous-femoral junction, medium thigh, knee, and medium leg (P ≤ .001). We analyzed 101 GSV tributaries. In the analysis of GSV tributaries by area, we identified a mean diameter decrease in all groups of tributaries (P < .001). Considering the tributaries with reflux, we also identified a reduction in the number of tributaries with reflux in all four groups (P ≤ .001). All tributaries were patent preoperatively; at 3 months after the surgical treatment, GSV tributaries occlusion was infrequent, except for the anterior thigh group. There was a decrease from 9 to 5 points in Venous Clinical Severity Score after EVLA (P < .001).</p><p><strong>Conclusions: </strong>This study demonstrated that, after GSV laser ablation, there was a statistically significant decrease in the diameters of all tributary groups, and the number of tributaries with decreased reflux; however, the occlusion of tributaries was not a frequent finding.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Morphofunctional evaluation of great saphenous vein's tributaries after thermoablation: A case series.\",\"authors\":\"Flávia Lins Bezerra de Souza Fonseca, Esdras Marques Lins, Emmanuelle Tenório Albuquerque Godoi, Henrique Jorge Guedes, Ana Júlia Xavier de Mendoza, Camila Beatriz Serrano de Oliveira\",\"doi\":\"10.1016/j.jvsv.2024.101986\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study evaluates hemodynamic and anatomic changes in great saphenous vein (GSV) tributaries after endovenous laser ablation (EVLA).</p><p><strong>Methods: </strong>This case series analyzed 112 areas in 28 lower limbs of 25 patients who underwent EVLA from April 2022 to June 2023 at the Hospital das Clínicas de Pernambuco/UFPE. All patients were evaluated by Doppler ultrasound preoperatively and 3 months after the surgical treatment. The parameters studied were GSV diameter and patency, GSV tributary diameter, patency and flow direction, and the Venous Clinical Severity Score after EVLA. The GSV characteristics were evaluated in four regions: saphenous-femoral junction, medium thigh, knee, and medium leg. The tributary veins were grouped in four areas: anterior thigh, posterior thigh, anterior leg, and posterior leg.</p><p><strong>Results: </strong>The results included 28 lower limbs from 23 patients; 18 patients (67.9%) were women, and the average age was 49 years; 2 patients were lost to follow-up. Ninety days after EVLA, all treated GSVs were occluded. The average diameter of GSV decreased in all four regions studied: saphenous-femoral junction, medium thigh, knee, and medium leg (P ≤ .001). We analyzed 101 GSV tributaries. In the analysis of GSV tributaries by area, we identified a mean diameter decrease in all groups of tributaries (P < .001). Considering the tributaries with reflux, we also identified a reduction in the number of tributaries with reflux in all four groups (P ≤ .001). All tributaries were patent preoperatively; at 3 months after the surgical treatment, GSV tributaries occlusion was infrequent, except for the anterior thigh group. There was a decrease from 9 to 5 points in Venous Clinical Severity Score after EVLA (P < .001).</p><p><strong>Conclusions: </strong>This study demonstrated that, after GSV laser ablation, there was a statistically significant decrease in the diameters of all tributary groups, and the number of tributaries with decreased reflux; however, the occlusion of tributaries was not a frequent finding.</p>\",\"PeriodicalId\":17537,\"journal\":{\"name\":\"Journal of vascular surgery. 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Morphofunctional evaluation of great saphenous vein's tributaries after thermoablation: A case series.
Objective: This study evaluates hemodynamic and anatomic changes in great saphenous vein (GSV) tributaries after endovenous laser ablation (EVLA).
Methods: This case series analyzed 112 areas in 28 lower limbs of 25 patients who underwent EVLA from April 2022 to June 2023 at the Hospital das Clínicas de Pernambuco/UFPE. All patients were evaluated by Doppler ultrasound preoperatively and 3 months after the surgical treatment. The parameters studied were GSV diameter and patency, GSV tributary diameter, patency and flow direction, and the Venous Clinical Severity Score after EVLA. The GSV characteristics were evaluated in four regions: saphenous-femoral junction, medium thigh, knee, and medium leg. The tributary veins were grouped in four areas: anterior thigh, posterior thigh, anterior leg, and posterior leg.
Results: The results included 28 lower limbs from 23 patients; 18 patients (67.9%) were women, and the average age was 49 years; 2 patients were lost to follow-up. Ninety days after EVLA, all treated GSVs were occluded. The average diameter of GSV decreased in all four regions studied: saphenous-femoral junction, medium thigh, knee, and medium leg (P ≤ .001). We analyzed 101 GSV tributaries. In the analysis of GSV tributaries by area, we identified a mean diameter decrease in all groups of tributaries (P < .001). Considering the tributaries with reflux, we also identified a reduction in the number of tributaries with reflux in all four groups (P ≤ .001). All tributaries were patent preoperatively; at 3 months after the surgical treatment, GSV tributaries occlusion was infrequent, except for the anterior thigh group. There was a decrease from 9 to 5 points in Venous Clinical Severity Score after EVLA (P < .001).
Conclusions: This study demonstrated that, after GSV laser ablation, there was a statistically significant decrease in the diameters of all tributary groups, and the number of tributaries with decreased reflux; however, the occlusion of tributaries was not a frequent finding.
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.
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