在动物模型中比较VELEXTM导管空静脉消融（EVA）技术、静脉内激光消融（EVLA）和泡沫硬化治疗（FS）对静脉壁的影响。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders Pub Date : 2025-04-23 DOI:10.1016/j.jvsv.2025.102251

Mario Salerno MD , Daniele Bissacco MD , Yung-Wei Chi MD , Sriram Narayanan MD , Alessandro Addis DVM , Fabio Martelli MSc, PhD , Germana Zaccagnini MSc , Teresa Lucia Aloi MD , Giovanni Nano MD , Sergio Gianesini MD, PhD , Paolo Righini MD

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引用次数: 0

摘要

目的：描述绵羊体内模型经空静脉消融（EVA）技术、静脉内激光消融（EVLA）技术和泡沫硬化治疗（FS）后的残余内膜和平均中膜厚度。方法：对6条羊髂股静脉轴和2条羊颈静脉轴进行EVA治疗（使用聚多酚[POL] 0.5%或1%，接触时间1或3分钟），FS治疗（在Valsalva手法中使用FS-1和FS [FS- val]， POL 1%治疗10分钟），EVLA治疗（径向1470 nm， 80焦耳/cm2）。结果：eva - pol0.5 ~ 1min平均内膜残留百分比为2% (IQR 1 ~ 4%), eva - pol0.5 ~ 3min平均内膜残留百分比为1% (IQR 0 ~ 3.5%)， eva - pol1 ~ 1min平均内膜残留百分比为2% (IQR 0 ~ 4%)， eva - pol1 ~ 3min平均内膜残留百分比为0，FS为13% (IQR 13 ~ 15.7%)， FS- val为1% (IQR 0 ~ 3%)， EVLA为1% （IQR 0 ~ 6%）。eva - pol0.5 -1min残余介质厚度平均百分比为13% (IQR 8-15%), eva - pol0.5 -3min为6% (IQR 4-9%)， eva - pol1 -1min为13% (IQR 10-27%)， eva - pol1 -3min为6% (IQR 5-12%)， FS为51% (IQR 40-62%)， FS- val为29% (IQR 23-35%)， EVLA为62% （IQR 41-75%）。结论：EVA在血管内膜和中膜层均优于EVLA和FS。

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Comparing venous wall effects using the empty vein ablation technique with VELEX catheter, endovenous laser ablation and foam sclerotherapy in an animal model

Objective

To describe residual intima and the average media thickness persisted after the empty vein ablation (EVA) technique, endovenous laser ablation (EVLA), and foam sclerotherapy (FS) in a sheep in vivo model.

Methods

Six iliofemoral and two jugular sheep vein axes were treated as follows: four with EVA (using polidocanol [POL] 0.5% or 1% with 1 or 3 minutes as contact time), two with FS (FS-1 and FS during Valsalva maneuver [FS-Val], POL1% for 10 minutes), and two with EVLA (1470 nm radial, 80 J/cm²).

Results

The average percentage of residual intima layer was 2% (interquartile range [IQR]: 1%-4%) for EVA-POL0.5%-1 minute, 1% (IQR: 0%-3.5%) for EVA-POL0.5%-3 minutes, 2% (IQR: 0%-4%) for EVA-POL1%-1 minute, 0 for EVA-POL1%-3 minutes, 13% (IQR: 13%-15.7%) for FS, 1% (IQR: 0%-3%) for FS-Val, and 1% (IQR: 0%-6%) for EVLA. The average percentage of residual media thickness was 13% (IQR: 8%-15%) for EVA-POL0.5%-1 minute, 6% (IQR: 4%-9%) for EVA-POL0.5%-3 minutes, 13% (IQR: 10%-27%) for EVA-POL1%-1 minute, 6% (IQR: 5%-12%) for EVA-POL1%-3 minutes, 51% (IQR: 40%-62%) for FS, 29% (IQR: 23%-35%) for FS-Val, and 62% (IQR: 41%-75%) for EVLA.

Conclusions

EVA demonstrated better results in vein wall damage compared with EVLA and FS, both in intima and media layers.

Clinical Relevance

This study provides crucial insights into the effectiveness of different vein treatment techniques, particularly the empty vein ablation method, in minimizing residual intima and media thickness. By evaluating these outcomes in a sheep model, it highlights how empty vein ablation may lead to more vein wall damage compared with endovenous laser ablation and foam sclerotherapy. For clinicians, understanding the comparative efficacy of these treatments is vital for optimizing patient care in managing venous diseases. As the field evolves, these findings could influence clinical decision-making, encouraging the adoption of techniques that promote better long-term outcomes for patients.

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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.