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Nasser MM, Ghoneim B, El Daly W, El Mahdy H. Comparative study between endovenous laser ablation (EVLA) with 1940 nm versus EVLA with 1470 nm for treatment of incompetent great saphenous vein and short saphenous vein: a randomized controlled trial. J Vasc Surg Venous Lymphat Disord 2024:101960. [PMID: 39111700 DOI: 10.1016/j.jvsv.2024.101960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 06/14/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND To date, the most commonly used endothermal ablation method is endovenous laser ablation (EVLA). The objective of this work is to assess the initial and short-term outcomes of a 1940 nm diode laser compared with 1470 nm diode laser utilization for the treatment of lower limb varicose veins. METHODS This is a randomized controlled prospective study that included patients with varicose veins. The allocated patients were randomized according to the technique used: group I, which was treated using EVLA with a 1940 nm diode laser, and group II, which was treated using EVLA with a 1470 nm diode laser. RESULTS This study initially included 216 patients. After the exclusion of patients lost during follow-up, group I consisted of 105 patients, and group II consisted of 101 patients. There were high rates of anatomical success in the two groups with obliteration of the treated vessels at the 1-month follow-up (100% and 99%, respectively) and the 6-month follow-up (100% and 99%, respectively). A very low rate of adverse events was encountered (1%). Group II showed obviously longer median days to return for usual activities (11.5 compared with 7 days). They showed significantly higher pain scores, which was evident at the 7-day and 1-month follow-ups (P < .001). CONCLUSIONS Both lasers provided excellent outcomes in terms of anatomical success and low rates of adverse events. The 1940 nm diode laser was associated with lower median days to return for usual activities and significantly lower pain scores. Evidently, lower power and linear endovenous energy density were required for this laser.
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Affiliation(s)
- Mahmoud M Nasser
- Vascular and Endovascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Baker Ghoneim
- Vascular and Endovascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt; Vascular and Endovascular Surgery, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
| | - Walid El Daly
- Vascular and Endovascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hossam El Mahdy
- Vascular and Endovascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Verbist J, Laeremans V, Gryffroy F, Van den Eynde W, Heerinckx C, Haesen D. Durability and efficacy of the ELVeS® Radial® 2ring slim fiber for multiple ablations. Phlebology 2023; 38:641-648. [PMID: 37545129 DOI: 10.1177/02683555231193883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVES To prove that the ELVeS® Radial® 2ring slim fiber (Biolitec AG, Wien, Austria) is safe and effective, with a reliable fiber durability. METHODS This prospective, non-randomized, registry recruited patients with venous incompetence of the great saphenous vein, with or without concomitant incompetence of the small, anterior accessory and posterior accessory saphenous veins. Anatomic success, clinical success and pain were assessed. RESULTS 150 patients (410 veins) underwent endovenous laser ablation (EVLA). Mean number of veins treated was 2.7 (1-7) with a mean total length of 80.7 cm. 98.3% occlusions were observed after 12 months. Clinical improvement was significant with reduced venous clinical severity scores at 1 month (1.7 ±1.9; p < .0001) and 12 months (0.7 ±1.3; p < .0001) versus pre-operation (4.4 ± 2.2). Mean pain level after 1-week was 5.8/100. No major surgery- or device-related complications occurred. CONCLUSIONS 1470-nm EVLA with the 2ring slim fiber is a highly effective treatment option well tolerated by patients. Despite intensive use, fiber integrity was preserved. CLINICAL REGISTRATION The study protocol was registered in clinicaltrials.gov (NCT03810677).
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Affiliation(s)
- Jürgen Verbist
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
| | - Veerle Laeremans
- Department of Vascular Surgery, Jessa Hospital, Hasselt, Belgium
| | - Fien Gryffroy
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
| | - Wouter Van den Eynde
- Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium
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Chen X, Liu Z, Zhou B, Fan Z, Zhao H, Lin C. Application of femoral nerve block combined with modified swelling anesthesia in high ligation and stripping of great saphenous vein. Front Surg 2023; 9:1086735. [PMID: 36684302 PMCID: PMC9854127 DOI: 10.3389/fsurg.2022.1086735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 01/07/2023] Open
Abstract
Background To analyze and explore the clinical efficacy of ultrasound guided femoral nerve block combined with modified swelling anesthetic solution in high ligation and stripping of the great saphenous vein. Methods 90 patients with varicose great saphenous vein of lower limbs undergoing high ligation and stripping of great saphenous vein were randomly divided into group A (femoral nerve block combined with modified swelling anesthesia), group B (simple swelling anesthesia) and group C (epidural anesthesia), with 30 patients in each group. The serum CRP level, operation duration, intraoperative blood loss, postoperative hospitalization time, total hospitalization cost, postoperative VAS score, preoperative and postoperative VCSS score, intraoperative mean arterial pressure and heart rate, postoperative related complications, and patients, satisfaction with diagnosis and treatment were compared among the three groups. Results There was no significant difference in operation duration, intraoperative blood loss, postoperative complications, and preoperative and postoperative VCSS scores among the three groups (P > 0.05). The postoperative hospitalization time, postoperative VAS score and total hospitalization cost of patients in group A and B were lower than those in group C, and the postoperative hospitalization time and postoperative VAS score in group A were more significant (P < 0.05). Compared with group B, the fluctuation range of intraoperative mean arterial pressure and heart rate, and postoperative serum CRP level in group A and C were lower, especially in group A (P < 0.05). The three groups of patients were followed up regularly after surgery. The results showed that the number of postoperative complications in group A was lower than that in the other two groups (P < 0.05), and the postoperative complications of the three groups were effectively relieved after symptomatic treatment (dressing change, anti-infection, taking drugs to improve circulation, etc.). The satisfaction of patients in group A was significantly higher than that in groups B and C (P < 0.05). Conclusions Ultrasound guided femoral nerve block combined with modified swelling anesthetic solution applied in high ligation and stripping of the great saphenous vein can significantly improve postoperative inflammatory stress reaction of patients, effectively ensure the safety and reliability of surgical progress, help to improve analgesia effect and accelerate physical rehabilitation, and has short hospitalization time, low medical cost, and high satisfaction of patients' diagnosis and treatment, which is worthy of widespread clinical promotion and reference.
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Affiliation(s)
- Xiaobin Chen
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China,Department of General Surgery, 900th Hospital of Joint Logistics Support Force; Fuzhou, China,Department of General Surgery, Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Fuzhou, China
| | - Zhenwen Liu
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Binbin Zhou
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Zuyou Fan
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Hu Zhao
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China,Department of General Surgery, 900th Hospital of Joint Logistics Support Force; Fuzhou, China,Department of General Surgery, Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Fuzhou, China,Correspondence: Chen Lin Hu Zhao
| | - Chen Lin
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China,Department of General Surgery, 900th Hospital of Joint Logistics Support Force; Fuzhou, China,Department of General Surgery, Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Fuzhou, China,Correspondence: Chen Lin Hu Zhao
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Liu P, Peng JL, Zhang F, Wang ZB, Zhang M, Niu XP, Su HY, Han YR, Wang YY. Comparison of Modified Above-Knee and Conventional Surgery with the Stripping of the Great Saphenous Vein of Varicose Veins of the Lower Extremities: A Retrospective Study. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7730960. [PMID: 35069794 PMCID: PMC8769814 DOI: 10.1155/2022/7730960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare the clinical effects of modified above-knee and conventional surgery with the stripping of the great saphenous vein of varicose veins of the lower extremities. METHODS Clinical data of patients with a varicose vein of the lower extremity from May 2016 to May 2018 were collected. A retrospective study was conducted on the patients receiving modified above-knee and conventional surgery with the great saphenous vein stripping. The baseline characteristics and long-term follow-up data were compared between the groups. RESULTS There were no significant differences in baseline characteristics between the two groups (P > 0.05). The surgeries were successfully performed by the same group of surgeons under local anesthesia and neuraxial anesthesia. The hospital stay, operation time, intraoperative blood loss, total length, and number of incisions in the above-knee group were comparable to those in the conventional surgery group (P > 0.05). The incidence of saphenous nerve injury and subcutaneous hematoma in the above-knee group was lower than that in the conventional surgery group (P < 0.05). There were no significant differences in recurrent varicose vein incidences (P > 0.05). After surgery, the venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ-14) scores of both groups were higher than those before operation (P < 0.05). There was no significant difference in VCSS score or CIVIQ-14 scores between the two groups postoperation (P > 0.05). At 24 months after surgery, the above-knee group (71.8%) and conventional surgery group (73.2%) resulted in changes of at least two CEAP-C clinical classes lower than baseline, respectively. CONCLUSION The modified above-knee technique can ensure clinical outcomes, reduce intraoperative blood loss and complication incidences, and shorten the operative time. This gives evidence that the modified above-knee technique is worthy of clinical application.
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Affiliation(s)
- Peng Liu
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Jun-lu Peng
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Feng Zhang
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Zi-bin Wang
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Miao Zhang
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Xu-peng Niu
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Hai-ying Su
- Department of General Surgery, Jing Zhong Medical Area of PLA General Hospital, Beijing 100036, China
| | - Ya-ru Han
- Department of Vascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Yuan-yuan Wang
- Department of Gastrointestinal Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
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Gawas M, Bains A, Janghu S, Kamat P, Chawla P. A Comprehensive Review on Varicose Veins: Preventive Measures and Different Treatments. J Am Coll Nutr 2021; 41:499-510. [PMID: 34242131 DOI: 10.1080/07315724.2021.1909510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this article was to review the different preventive measures and treatments for varicose veins disease. Varicose veins are tortuous, enlarged veins that are usually found in the lower extremities damages blood vessels leading to its painful swelling cause's blood clots, affecting people over increasing prevalence with age and affects the proficiency, productivity, and life quality of a person. Prolonged standing and obesity are the major reason for varicose vein disease. The mechanisms, prevention, risk factors, complications, and treatment of varicose veins are explained in this review. Various types of treatments such as endovascular, surgical, and herbal treatments improve quality of life and reduce the secondary complications of varicose veins. Besides these methods of treatments, varicose vein disease can be prevented by doing regular yoga/exercise and consumption of several fruits and vegetables such as Grapes, blackberries, avocados, ginger, and rosemary. Typically, varicose veins can be a benign process with several problems that can influence the life quality of an individual that can lead to potentially life-threatening complications. However, there are numerous surgical, endovascular, and chemical treatments that improve quality of life and decrease secondary complications of varicose veins. Patients with varicose veins should take an antioxidant medicament from the flavonoid groups to reduce the arterial blood pressure value, risk of atherosclerosis development, prevent thrombotic incidents.Key teaching pointsChronic venous disease is a pathological state of vein circulatory systems of the lower limbsProlonged standing and obesity are the major reason for varicose vein diseaseEndovascular, surgical, and herbal treatments improve quality of life and reduce the secondary complications of varicose veinsVenoactive drugs such as flavonoids, saponins, and others have a therapeutic effect on chronic venous disordersPhlebotropic drugs are semi-synthetic substances widely used in different states of chronic venous insufficiencyFood rich in phytoconstituents are more effective in varicose veins.
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Affiliation(s)
- Mandar Gawas
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| | - Aarti Bains
- Department of Biotechnology, Chandigarh group of Colleges Landran, Mohali, Punjab, India
| | - Sandeep Janghu
- Indian Institute of Food Processing Technology, Thanjavur, Tamilnadu, India
| | - Pranali Kamat
- Department of Pharmacy, Goa College of Pharmacy, Panaji, Goa, India
| | - Prince Chawla
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
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Ulloa JH, Comerota A, Figueroa V, Cifuentes S. GREAT SAPHENOUS VEIN OCCLUSION RATES AFTER COMBINED TREATMENT WITH LASER AND FOAM SCLEROTHERAPY. J Vasc Surg Venous Lymphat Disord 2021; 9:1437-1442. [PMID: 34174499 DOI: 10.1016/j.jvsv.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Endovenous Laser Ablation (EVLA) and foam sclerotherapy are effective and safe treatments for chronic venous disease (CVD) with great saphenous vein (GSV) reflux. We report our experience combining both strategies as a merged approach to treat GSV incompetence to potentiate both methods' superiority and benefits. We aimed to determine the effectiveness of this treatment strategy. METHODS 246 limbs with great saphenous vein incompetence (C2-C6) treated with EVLA and foam sclerotherapy between January 2016 and December 2019 were retrospectively analyzed. Outcomes of interest were the International Union of Phlebology type of anatomic closure (primary, primary assisted, secondary and therapeutic failure), identified with ultrasound in the GSV after the procedure. Clinical and ultrasound follow-up was conducted at two weeks, 3, 6, and 12 months post-intervention. We utilized Fisher's exact test to determine the significance of the association between the type of anatomic closure and the clinical stage according to the CEAP classification. RESULTS 67% of the treated limbs were C2-C4 and 33% C5-C6. International Union of Phlebology (IUP) primary closure was achieved in 229 limbs (93%), IUP primary assisted closure in 10 (4%), IUP secondary closure in 1 (0.4%), with therapeutic failure in 6 limbs (2%). Forty-five limbs (18%) required microthrombectomies of tributary veins due to local induration, 7 (2.8%) developed dyschromia, 4 (1.6%) had type 1 Endovenous Heat-Induced Thrombosis (E-HIT1), and one limb (0.4%) developed deep vein thrombosis (DVT), which was successfully treated with anticoagulation. CONCLUSIONS Our results demonstrate a high occlusion rate of incompetent GSVs with combined EVLA and foam sclerotherapy with infrequent non-serious complications and one case of subclinical isolated popliteal DVT. Combined therapy effectiveness and safety are comparable with other endovenous treatments for CVD with GSV reflux. The use of both thermal and chemical ablation combines the benefits of both techniques.
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Affiliation(s)
- Jorge H Ulloa
- Division of Vascular Surgery, Department of Surgery, Universidad de los Andes, Bogota, Colombia; Division of Vascular Surgery, Department of Surgery, Fundacion Santa Fe de Bogota, Bogota, Colombia.
| | | | - Valentin Figueroa
- Division of Vascular Surgery, Department of Surgery, Universidad de los Andes, Bogota, Colombia; Division of Vascular Surgery, Department of Surgery, Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Sebastian Cifuentes
- Division of Vascular Surgery, Department of Surgery, Universidad de los Andes, Bogota, Colombia; Division of Vascular Surgery, Department of Surgery, Fundacion Santa Fe de Bogota, Bogota, Colombia
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Kuserli Y, Kavala AA, Turkyilmaz S. Comparison of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers: Retrospective cohort with five-year follow-up. Vascular 2021; 30:375-383. [PMID: 33896291 DOI: 10.1177/17085381211011356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the use of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers. METHODS One hundred ninety-five (n = 195) subjects who were treated for venous leg ulcers were enrolled between 2009 and 2014. Three groups were formed (Group A: high saphenous ligation and total stripping, Group B: radiofrequency ablation of the great saphenous vein + perforators, and Group C: radiofrequency ablation of the great saphenous vein + subfascial endoscopic perforator surgery) (n = 65 for each group). The venous clinical severity score for baseline, 1st, 6th, and 12th months, great saphenous vein occlusion at the 1st, 6th, and 12th months, and ulcer rates for the 1st, 2nd, 3rd, 4th, and 5th years were recorded. RESULTS For venous clinical severity score, only the first month decrease was significant for the subfascial endoscopic perforator surgery group (p = 0.001). Great saphenous vein occlusion was higher at the 6th and 12th months for the high saphenous ligation and stripping and subfascial endoscopic perforator surgery groups than for the radiofrequency ablation group (p = 0.036 and p = 0.037). The rate of ulcers for the subfascial endoscopic perforator surgery group was lower at the second, third, fourth, and fifth years (p = 0.011). No significant difference was found between groups for the five-year recovery rates (p > 0.05). CONCLUSION Subfascial endoscopic perforator surgery technique in conjunction with radiofrequency ablation of axial vein was superior to both high saphenous ligation and stripping and radiofrequency ablation of axial and perforators for ulcer healing.
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Affiliation(s)
- Yusuf Kuserli
- Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ali Aycan Kavala
- Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Saygin Turkyilmaz
- Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Rai A, Porsalman M, Khatony A, Sobhiyeh M. Comparison of foam sclerotherapy versus radiofrequency ablation in the treatment of primary varicose veins due to incompetent great saphenous vein: Randomized clinical trial. JOURNAL OF VASCULAR NURSING 2019; 37:226-231. [PMID: 31847976 DOI: 10.1016/j.jvn.2019.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Minimally invasive procedures such as foam sclerotherapy and radiofrequency ablation (RFA) have gained attention for treatment of incompetent great saphenous vein (GSV). The objective of this study was to compare recurrence rate and quality of life between foam sclerotherapy and RFA in patients with incompetent GSV varicose veins. METHODS In this parallel single-blinded randomized clinical trial, 60 adult patients with primary varicose veins due to incompetent GSV (CEAP classes C2-4EPAsPr) were included and randomly divided to receive RFA or foam sclerotherapy. Health-related quality of life (HRQOL) was assessed by the Short Form 36, and the Aberdeen Varicose Vein Questionnaire (AVVQ) was applied to assess the impact of varicose veins on quality of life of the patients. In addition, pain severity after the procedures was investigated by a visual analog scale (VAS) (range, 0 to 10). The patients were followed at 1 week, 1 month, 3 months, and 6 months postoperation. GSV reflux and recurrence was assessed by color Doppler ultrasound examination after 6 months. RESULTS Twenty-eight patients in RFA and 27 patients in foam sclerotherapy remained for the final analyses. The time interval from the procedure and recovery to daily normal activities was 1 day in both groups. Mean (±SD) pain VAS score in RFA group decreased from preintervention score of 7.35 (±3.28) to 1.21 (±0.68); P < .0001. Likewise, this score decreased from 6.64 (±2.04) to 1.29 (±0.91) in foam sclerotherapy group. HRQOL scores increased gradually at 1, 3, and 6 months after the intervention. AVVQ scores decreased significantly 1 week postintervention in both groups. After 6 months, 17.9% (5 patients) in RFA group and 14.8% (4 patients) in foam sclerotherapy group had recurrence of GSV reflux (P = .52). CONCLUSION Both foam sclerotherapy and RFA were effective in treatment of GSV reflux. Comparable findings were observed between the 2 groups regarding postoperative pain, recovery time, HRQOL, and AVVQ scores.
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Affiliation(s)
- Alireza Rai
- Department of Cardiology, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahtab Porsalman
- Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Department of Community Health, Medical Surgical Nursing, School of Nursing and Midwifery, Infectious Diseases Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammadreza Sobhiyeh
- Department of Vascular and Endovascular Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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