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The effect of endovenous laser ablation of incompetent perforating veins and the great saphenous vein in patients with primary venous disease.
Eur J Vasc Endovasc Surg. 2015 May; 49(5):574-80.EJ

Abstract

OBJECTIVE/BACKGROUND

This study aimed to investigate the clinical results and fate of incompetent perforating veins (IPVs) following treatment of superficial venous insufficiency, with or without endovenous laser ablation (EVLA) of IPVs.

METHODS

A retrospective analysis of patients with primary venous insufficiency (PVI) was conducted in a single institution from January, 2010 to December, 2011. IPVs were found in 311 patients (376 limbs). Among these, 132 patients (156 limbs) were treated with EVLA of IPVs and varicose vein surgery, and the remaining 179 patients (220 limbs) were treated with varicose vein surgery alone and served as controls. The fate of the IPVs, complications and clinical results were evaluated.

RESULTS

The technical success rate of EVLA of IPVs was 100%. There was no statistical difference in complications between the two groups. At 1 year follow up, 68 perforators were recanalized and still incompetent in the EVLA treated IPV group compared with 437 incompetent perforators in the untreated IPV group (18.7% vs. 92.6%; p < .001). A faster median ulcer healing time (1.40 months) was found in the EVLA treated IPV group (95% confidence interval [CI] 1.15-1.66 vs. 3.30 months [95% CI 2.50-4.10]; p = .001), even though no statistical difference in the 12 month ulcer healing rate was observed between the two groups (p = .584). There were no significant differences between the two groups for varicose vein recurrence rates or changes in the Venous Clinical Severity Score (VCSS).

CONCLUSION

EVLA was safe and effective in reducing the number of IPVs in PVI. However, the addition of IPV EVLA had no effect on ulcer healing rate, VCSS or varicose vein recurrence at 1 year follow up.

Authors+Show Affiliations

Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, 639 Zhizaouju Rd, Shanghai, 200011, China.Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, 639 Zhizaouju Rd, Shanghai, 200011, China.Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, 639 Zhizaouju Rd, Shanghai, 200011, China.Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, 639 Zhizaouju Rd, Shanghai, 200011, China.Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, 639 Zhizaouju Rd, Shanghai, 200011, China.Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, 639 Zhizaouju Rd, Shanghai, 200011, China. Electronic address: yinminyi@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25754773

Citation

Shi, H, et al. "The Effect of Endovenous Laser Ablation of Incompetent Perforating Veins and the Great Saphenous Vein in Patients With Primary Venous Disease." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 49, no. 5, 2015, pp. 574-80.
Shi H, Liu X, Lu M, et al. The effect of endovenous laser ablation of incompetent perforating veins and the great saphenous vein in patients with primary venous disease. Eur J Vasc Endovasc Surg. 2015;49(5):574-80.
Shi, H., Liu, X., Lu, M., Lu, X., Jiang, M., & Yin, M. (2015). The effect of endovenous laser ablation of incompetent perforating veins and the great saphenous vein in patients with primary venous disease. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 49(5), 574-80. https://doi.org/10.1016/j.ejvs.2015.01.013
Shi H, et al. The Effect of Endovenous Laser Ablation of Incompetent Perforating Veins and the Great Saphenous Vein in Patients With Primary Venous Disease. Eur J Vasc Endovasc Surg. 2015;49(5):574-80. PubMed PMID: 25754773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of endovenous laser ablation of incompetent perforating veins and the great saphenous vein in patients with primary venous disease. AU - Shi,H, AU - Liu,X, AU - Lu,M, AU - Lu,X, AU - Jiang,M, AU - Yin,M, Y1 - 2015/03/05/ PY - 2014/10/15/received PY - 2015/01/22/accepted PY - 2015/3/11/entrez PY - 2015/3/11/pubmed PY - 2015/7/18/medline KW - Endovenous laser ablation KW - Perforating veins KW - Primary venous insufficiency SP - 574 EP - 80 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 49 IS - 5 N2 - OBJECTIVE/BACKGROUND: This study aimed to investigate the clinical results and fate of incompetent perforating veins (IPVs) following treatment of superficial venous insufficiency, with or without endovenous laser ablation (EVLA) of IPVs. METHODS: A retrospective analysis of patients with primary venous insufficiency (PVI) was conducted in a single institution from January, 2010 to December, 2011. IPVs were found in 311 patients (376 limbs). Among these, 132 patients (156 limbs) were treated with EVLA of IPVs and varicose vein surgery, and the remaining 179 patients (220 limbs) were treated with varicose vein surgery alone and served as controls. The fate of the IPVs, complications and clinical results were evaluated. RESULTS: The technical success rate of EVLA of IPVs was 100%. There was no statistical difference in complications between the two groups. At 1 year follow up, 68 perforators were recanalized and still incompetent in the EVLA treated IPV group compared with 437 incompetent perforators in the untreated IPV group (18.7% vs. 92.6%; p < .001). A faster median ulcer healing time (1.40 months) was found in the EVLA treated IPV group (95% confidence interval [CI] 1.15-1.66 vs. 3.30 months [95% CI 2.50-4.10]; p = .001), even though no statistical difference in the 12 month ulcer healing rate was observed between the two groups (p = .584). There were no significant differences between the two groups for varicose vein recurrence rates or changes in the Venous Clinical Severity Score (VCSS). CONCLUSION: EVLA was safe and effective in reducing the number of IPVs in PVI. However, the addition of IPV EVLA had no effect on ulcer healing rate, VCSS or varicose vein recurrence at 1 year follow up. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/25754773/The_effect_of_endovenous_laser_ablation_of_incompetent_perforating_veins_and_the_great_saphenous_vein_in_patients_with_primary_venous_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(15)00054-4 DB - PRIME DP - Unbound Medicine ER -