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Update of the SFMV (French society of vascular medicine) guidelines on the conditions and safety measures necessary for thermal ablation of the saphenous veins and proposals for unresolved issues.
J Med Vasc. 2020 May; 45(3):130-146.JM

Abstract

Venous insufficiency is a very common disease affecting about 25% of the French population (if we combine all stages of its progression). It is a complex disease and its aetiology has not yet been fully elucidated. Some of its causes are well known, such as valvular dysfunction, vein wall defect, and the suctioning effect common to all varicose veins. These factors are generally associated and together lead to dysfunction of one or more of the saphenous veins. Saphenous vein dysfunction is revealed by ultrasound scan, a reflux lasting more than 0.5 seconds indicating venous incompetence. The potential consequences of saphenous vein dysfunction over time include: symptoms (heaviness, swellings, restlessness, cramps, itching of the lower limbs), acute complications (superficial venous thrombosis, varicose bleeding), chronic complications (changes in skin texture and colour, stasis dermatitis, eczema, vein atresia, leg ulcer), and appearance of unaesthetic varicose veins. It is not possible to repair an incompetent saphenous vein. The only therapeutic options at present are ultrasound-guided foam sclerotherapy, physical removal of the vein (saphenous stripping), or its thermal ablation (by laser or radiofrequency treatment), the latter strategy having now become the gold standard as recommended by international guidelines. Recommendations concerning thermal ablation of saphenous veins were published in 2014 by the Société française de médecine vasculaire. Our society has now decided to update these recommendations, taking this opportunity to discuss unresolved issues and issues not addressed in the original guidelines. Thermal ablation of an incompetent saphenous vein consists in destroying this by means of a heating element introduced via ultrasound-guided venous puncture. The heating element comprises either a laser fibre or a radiofrequency catheter. The practitioner must provide the patient with full information about the procedure and obtain his/her consent prior to its implementation. The checklist concerning the interventional procedure issued by the HAS should be validated for each patient (see the appended document).

Authors+Show Affiliations

Clinique de l'Atlantique, 17138 Puilboreau-La Rochelle, France. Electronic address: sebastiengracia17@gmail.com.Cabinet de Médecine Vasculaire, 78120 Rambouillet, France.Hôpital Robert-Pax, 57200 Sarreguemines, France.Hopital de Vichy, 03200 Vichy, France.Cabinet de Médecine Vasculaire, 28100 Dreux, France.Cabinet de Médecine Vasculaire, 24100 Bergerac, France.Cabinet de Médecine Vasculaire, 64200 Biarritz, France.Clinique Ambroise Paré, 54100 Nancy, France.Hôpital Privé des Côtes d'Armor, 22190 Plérin, France.Service d'Anesthésie et Réanimation Chirurgicale, Centre Hospitalier Universitaire de Nantes, 44000 Nantes, France.Clinique Sainte Anne, 33210 Langon, France.Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Nice, 06000 Nice, France.Clinique Saint-Charles, 85000 La Roche sur Yon, France.Centre Hospitalier Princesse Grace, Service Epidémiologie et Hygiène Hospitalière, 98000 Monaco, Monaco.Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France.Cabinet de Médecine Vasculaire, 76550 Saint-Aubin-sur-Scie, France.Centre de Médecine Vasculaire, 38000 Grenoble, France.Service de Médecine Vasculaire Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France.Unité de Médecine Vasculaire, Centre Hospitalier Universitaire de Rennes, 35000 Rennes, France.

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

32402427

Citation

Gracia, S, et al. "Update of the SFMV (French Society of Vascular Medicine) Guidelines On the Conditions and Safety Measures Necessary for Thermal Ablation of the Saphenous Veins and Proposals for Unresolved Issues." Journal De Medecine Vasculaire, vol. 45, no. 3, 2020, pp. 130-146.
Gracia S, Miserey G, Risse J, et al. Update of the SFMV (French society of vascular medicine) guidelines on the conditions and safety measures necessary for thermal ablation of the saphenous veins and proposals for unresolved issues. J Med Vasc. 2020;45(3):130-146.
Gracia, S., Miserey, G., Risse, J., Abbadie, F., Auvert, J. F., Chauzat, B., Combes, P., Creton, D., Creton, O., Da Mata, L., Diard, A., Giordana, P., Josnin, M., Keïta-Perse, O., Lasheras, A., Ouvry, P., Pichot, O., Skopinski, S., & Mahé, G. (2020). Update of the SFMV (French society of vascular medicine) guidelines on the conditions and safety measures necessary for thermal ablation of the saphenous veins and proposals for unresolved issues. Journal De Medecine Vasculaire, 45(3), 130-146. https://doi.org/10.1016/j.jdmv.2020.03.005
Gracia S, et al. Update of the SFMV (French Society of Vascular Medicine) Guidelines On the Conditions and Safety Measures Necessary for Thermal Ablation of the Saphenous Veins and Proposals for Unresolved Issues. J Med Vasc. 2020;45(3):130-146. PubMed PMID: 32402427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update of the SFMV (French society of vascular medicine) guidelines on the conditions and safety measures necessary for thermal ablation of the saphenous veins and proposals for unresolved issues. AU - Gracia,S, AU - Miserey,G, AU - Risse,J, AU - Abbadie,F, AU - Auvert,J F, AU - Chauzat,B, AU - Combes,P, AU - Creton,D, AU - Creton,O, AU - Da Mata,L, AU - Diard,A, AU - Giordana,P, AU - Josnin,M, AU - Keïta-Perse,O, AU - Lasheras,A, AU - Ouvry,P, AU - Pichot,O, AU - Skopinski,S, AU - Mahé,G, Y1 - 2020/04/15/ PY - 2020/5/14/entrez PY - 2020/5/14/pubmed PY - 2020/9/15/medline KW - 2020 KW - French Society of Vascular Medicine KW - Guideline KW - Saphenous veins KW - Thermal ablation KW - Update SP - 130 EP - 146 JF - Journal de medecine vasculaire JO - J Med Vasc VL - 45 IS - 3 N2 - Venous insufficiency is a very common disease affecting about 25% of the French population (if we combine all stages of its progression). It is a complex disease and its aetiology has not yet been fully elucidated. Some of its causes are well known, such as valvular dysfunction, vein wall defect, and the suctioning effect common to all varicose veins. These factors are generally associated and together lead to dysfunction of one or more of the saphenous veins. Saphenous vein dysfunction is revealed by ultrasound scan, a reflux lasting more than 0.5 seconds indicating venous incompetence. The potential consequences of saphenous vein dysfunction over time include: symptoms (heaviness, swellings, restlessness, cramps, itching of the lower limbs), acute complications (superficial venous thrombosis, varicose bleeding), chronic complications (changes in skin texture and colour, stasis dermatitis, eczema, vein atresia, leg ulcer), and appearance of unaesthetic varicose veins. It is not possible to repair an incompetent saphenous vein. The only therapeutic options at present are ultrasound-guided foam sclerotherapy, physical removal of the vein (saphenous stripping), or its thermal ablation (by laser or radiofrequency treatment), the latter strategy having now become the gold standard as recommended by international guidelines. Recommendations concerning thermal ablation of saphenous veins were published in 2014 by the Société française de médecine vasculaire. Our society has now decided to update these recommendations, taking this opportunity to discuss unresolved issues and issues not addressed in the original guidelines. Thermal ablation of an incompetent saphenous vein consists in destroying this by means of a heating element introduced via ultrasound-guided venous puncture. The heating element comprises either a laser fibre or a radiofrequency catheter. The practitioner must provide the patient with full information about the procedure and obtain his/her consent prior to its implementation. The checklist concerning the interventional procedure issued by the HAS should be validated for each patient (see the appended document). SN - 2542-4513 UR - https://www.unboundmedicine.com/medline/citation/32402427/Update_of_the_SFMV__French_society_of_vascular_medicine__guidelines_on_the_conditions_and_safety_measures_necessary_for_thermal_ablation_of_the_saphenous_veins_and_proposals_for_unresolved_issues_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2542-4513(20)30250-9 DB - PRIME DP - Unbound Medicine ER -