Steam Vein Sclerosis for Nonsaphenous varicose veins

IF 1.4 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Annals of vascular surgery Pub Date : 2025-02-01 DOI:10.1016/j.avsg.2024.10.016
J. Lacquemanne , C.C. Bamdé , F. Lareyre , E. Steinmetz , O. Creton
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Abstract

Background

The treatment of nonsaphenous varicose veins (NSVV), including incompetent perforating veins (IPV) and recurrent varicose veins (RVV), remains challenging for many reasons, including vein tortuosity, deep location and short vein to be treated. Data and recommendations are lacking. Steam vein sclerosis (SVS) is an endothermal therapy that has been used in the treatment of incompetent saphenous veins, achieving occlusion rates similar to other thermal ablation techniques with good patient tolerance and minimal postoperative pain. We report here the results of a cohort of SVS used to treat NSVV, including RVV and IPV.

Methods

From October 2017 to March 2020, consecutive patients presenting with NSVV treated with SVS were included. Patients were followed at 3 months with both clinical and duplex scan examinations. The primary endpoint was efficacy defined as target vein occlusion at 3 months; secondary endpoints were: safety with analysis of per procedural and 3 months complications, evolution of functional stage and symptoms between inclusion and 3 months.

Results

Ninety-six patients were included in the study. Five patients were lost to follow-up. Fifty-nine percent (n = 60) were women. Lesions were recurrent (recurrent varicose vein after surgery) in 61% (n = 62). The location of the NSVV was sapheno-femoral residual stump in 8% (n = 8), inguinal neovascularization in 14% (n = 14), sapheno-popliteal residual stump in 12% (n = 12), popliteal neovascularization in 7% (n = 7), and IPV in 59% (n = 60). Complete occlusion after treatment occurred in 86% (n = 83) of patients, partial occlusion in 4% (n = 4), and complete recanalization in 10% (n = 9). The occlusion rate in the IPV group was 93%. Complications at 30 days postoperatively were 2 (2%) deep vein thrombosis, 1 (1%) hematoma, and 2 (2%) late paresthesias in the superficial peroneal nerve area.

Conclusions

The use of SVS has been shown to be effective and safe in the short-term treatment of NSVV, including IPV and RVV. Further studies are needed to evaluate its long-term effects.
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蒸汽静脉硬化治疗非隐静脉曲张。
导言:非无表浅静脉曲张(NSVV),包括无功能穿孔静脉(IPV)和复发性静脉曲张(RVV),由于静脉迂曲、位置深、待治疗静脉短等诸多原因,其治疗仍具有挑战性。目前还缺乏相关数据和建议。蒸汽静脉硬化(SVS)是一种内热疗法,已被用于治疗无功能隐静脉,其闭塞率与其他热消融技术相似,患者耐受性良好,术后疼痛极小。我们在此报告一组 SVS 用于治疗 NSVV(包括 RVV 和 IPV)的结果:方法:从 2017 年 10 月至 2020 年 3 月,连续纳入了接受 SVS 治疗的 NSVV 患者。对患者进行3个月的临床和双相扫描检查。主要终点为疗效,定义为3个月时靶静脉闭塞;次要终点为安全性,分析每次手术和3个月时的并发症,纳入至3个月时功能分期和症状(VCSS)的演变:研究共纳入了 96 名患者。5 名患者失去了随访机会。59%(n=60)为女性。61%(n=62)的患者病变复发(术后复发性静脉曲张,REVAS)。NSVV的病变位置分别为:8%(8人)为隐股静脉残余,14%(14人)为腹股沟新生血管,12%(12人)为隐腘静脉残余,7%(7人)为腘静脉新生血管,59%(60人)为无功能穿孔静脉。治疗后完全闭塞的患者占 86%(83 人),部分闭塞的患者占 4%(4 人),完全再通畅的患者占 10%(9 人)。无静脉穿孔组的闭塞率为 93%。术后30天的并发症为2例(2%)深静脉血栓形成(DVT)、1例(1%)血肿和2例(2%)腓浅神经区域晚期麻痹:在短期治疗包括 IPV 和 RVV 在内的 NSVV 时,SVS 的使用已被证明是有效和安全的。需要进一步研究以评估其长期效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
13.30%
发文量
603
审稿时长
50 days
期刊介绍: Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence
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