Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: Analysis of early efficacy and complications

Division of Vascular Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Journal of Vascular Surgery (Impact Factor: 3.02). 09/2005; 42(3):488-93. DOI: 10.1016/j.jvs.2005.05.014
Source: PubMed


The clinical records of 92 consecutive patients who underwent endovenous GSV ablation over a 3-year period between June 1, 2001, and June 25, 2004, were retrospectively reviewed. Data on 130 extremities were included in the analysis. All patients had symptomatic varicose veins with documented GSV incompetence and were classified according to the CEAP (clinical, etiologic, anatomic, pathophysiologic) classification. Clinical data, operative details, and postoperative course were recorded and analyzed (Table I). The institutional review board approved the retrospective chart review of patients who underwent GSV ablation.

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Available from: Michele Carmo
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    • "The thrombosis extension from the SFJ into the common femoral vein (CFV) was observed since the introduction of EVA procedures in CVI treatment [9] [10] [11] [12] [13]. An Internet discussion moderated by the "
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    ABSTRACT: After any kind of endovenous ablation, including Laser, RF and chemical ablation, it's common to find a floating thrombus, extending from the termination of the greater saphenous vein (GSV) and in continuity with the closure in the treated GSV. Post Ablation Superficial Thrombus Extension (PASTE) is not a DVT, differing from the spontaneous floating thrombus in several features. Though isolated reports of thromboembolism, PASTE is not evolutive and requires only a planned monitoring at 1 week, generally disappearing spontaneously at 2 weeks. Some parameters can influence thrombosis extension in the saphenous femoral junction (SFJ) as the male gender and the distance of the device tip from the SFJ. Superficial epigastric vein is generally preserved in endovenous ablation (EVA) procedures in order to insure a distance to the SFJ and a washing vessel mechanism. Washing vessels date long before and were used in the treatment of the shorter saphenous vein. PASTE is a provoked thrombosis and also an answer to a planned injury, occurring in a well defined starting moment. EVA procedures are widely applied in the human, thus they are a very big source of observations to study the evolution of thrombosis.
    Full-text · Article · Jun 2014 · Reviews in Vascular Medicine
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    • "We observed a 7.7% rate of thrombus extension from the GSV into the femoral veins. Puggioni et al [14] from our group later found that, with experience, this incidence decreased to 2.3% and suggested that age (older than 50 years) can contribute to increased rate of thrombus extension into the femoral vein. "
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    ABSTRACT: Pulmonary embolism (PE) after venous procedures is fortunately rare. Our goal was to analyze the data of patients who developed PE after endovenous thermal ablation and phlebectomy for varicose veins and to review the literature on this subject. We report on three patients who developed PE after radiofrequency ablation of the great saphenous vein and mini phlebectomy for symptomatic primary lower-extremity varicose veins. Early postoperative duplex scans confirmed successful closure of the great saphenous vein in all. One patient presented with chest pain and dyspnea, one with blood-tinged sputum, and the third with symptoms of saphenous thrombophlebitis. Two patients had PE from the saphenous vein thrombus and the third had gastrocnemius vein thrombosis extending into the popliteal vein. One had previous deep vein thrombosis. Computed tomography of the chest confirmed PE in all. Two patients were treated with anticoagulation, but the third patient with small PE declined such treatment. One patient underwent temporary inferior vena cava filter placement because of recurrent PE. In conclusion, PE is very rare but it can occur after endovenous thermal ablation of lower-extremity varicose veins. Selective thrombosis prophylaxis and preoperative counseling of the patients about signs and symptoms of deep vein thrombosis and PE are warranted for early recognition and rapid treatment.
    Full-text · Article · Mar 2013 · Seminars in Vascular Surgery
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    • "83–98 [11] [13] [18] 65–77 [11] [12] [17] 1–6 months 94 [13] 89–91 [11] [13] [18] 1–4 years 93–97 [8] [9] [20] 67–96 [12] [18] DVT (%) 0–8 [8] [9] [29] 0–16 [11] [12] [13] [14] 5 [15] Bruising/hematoma (%) (1 week) 24 [8] 33 [11] 65 [11] Paresthesias (%) 0–8 [8] [9] [20] [32] 0–23 [11] [19] 14–40 [11] [16] of 210 limbs, 1.6% had numbness at the lateral malleolus postprocedure and successful SSV closure was demonstrated in 100% of limbs at 1 week and 96% of limbs at a mean follow-up of 4 months. Thrombus extension into the popliteal vein was seen in 5.7% of limbs, with limbs lacking a Giacomini extension branch at highest risk [22]. "
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    ABSTRACT: Endovenous laser treatment (EVLT) has become a standard therapy for the treatment of superficial venous insufficiency. It offers a rapid, office-based therapy with minimal patient downtime and an easier recovery than traditional surgical treatment. EVLT is effective and durable and can successfully treat saphenous truncal insufficiency and accessory branches with low complication rates. EVLT can increase patient satisfaction and enable the treatment of a wider variety of patients with a more efficient procedure compared with traditional techniques.
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