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Chirurgia 2020 February;33(1):24-9

DOI: 10.23736/S0394-9508.19.04967-2


lingua: Inglese

A comparison of choosing the best technique in endovenous ablation of varicose veins of the lower limbs

Bilal PERÇIN , Hakan SAÇLI

Department of Cardiovascular Surgery, Sakarya University Training and Research Hospital, Adapazarı Sakarya, Turkey

BACKGROUND: Endovenous ablation is very popular among vascular surgeons and patients especially for last ten years. Technologic development of the surgical techniques makes the demands for the lesser pain and bruising, shorter operation time, better quality of life and less time off work.
METHODS: The study is set for the determination of the preferences for the endovenous therapy and planned among the patients who had the diagnosis of venous insufficiency with doppler usg of the lower limbs (CEAP 2S) and were hospitalized in the Sakarya University Research and Training Hospital cardiovascular clinic. The primary aim of this study was to determine whether Biochemical Vein Ablation systems (BVA) of the great saphaenous vein (GSV) was associated with less pain and bruising than Radiofrequency Ablation (RFA)and Endovenous Laser Ablation (EVLA). The secondary aims were to assess efficacy of vein ablation and quality of life following these procedures. In total 402 patients of chronic venous insufficiency were taken to our study. Endovenous treatment methods were compared for the peroperative and postoperative comfort for the patient and the physician. Treatment procedures for EVLA the BioLITEC (Biolitec AG, Germany) and for RFA Covidien ClosureFast Endovenous Radiofrequency Ablation (RFA) Catheter (MA, USA) and for BVA (ClariVein catheter Vascular Insights, Madison, CT, USA). Aethoxysklerol 40 mg (2%) was used as the sclerosant material (Aethoxysklerol, Kreussler Pharma, Wiesbaden, Germany) were used. Phlebectomies were performed as required. Primary endpoints were patient assessed pain and bruising measured by visual analogue scale (VAS). Secondary endpoints were patency assessed by duplex ultrasound at 6 weeks and 6 months.
RESULTS: The operation was easier either to the physician and the patient in the BVA group. The pain and postoperative comfort were superior in both BVA and RFA groups in comparison to the EVLA group. There were no significant differences in mean postoperative pain, bruising and activity scores among BVA, RFA and EVLA groups. All BVA, RFA and EVLA resulted at least occlusion rates of 95% at 10 days postoperatively.
CONCLUSIONS: BVA and RFA was less painful for patients than EVLA and produced less bruising in the postoperative period with comparable success rates but there was no difference in the long-term results of the study.

KEY WORDS: Radiofrequency ablation; Laser; Biochemical phenomena; Varicose veins

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