About some tactical aspects of the use of radiofrequency ablation in The treatment of varicose disease of the lower extremities in outpatient care
DOI:
https://doi.org/10.11603/2414-4533.2020.4.11785Keywords:
mini-phlebectomy, echo-sclerotherapyAbstract
The aim of the work: to give clinical evaluation of the results of using radio frequency ablation in treating varicose veins in order to increase the indications for its implementation in the outpatient setting.
Materials and Methods. During 2016–2019, 928 patients with varicose veins C2-C4 were monitored for classification of CEAP. There were 538 (58 %) women, and 390 (42 %) men, aged from 18 to 72 years. To eliminate the vertical reset RFA was used according to the method of VNUS – Closure FAST, using the device COVIDIEN, Medtronics manufacturer.
Results and Discussion. The ultrasound examination of the stem of saphenous veins demonstrated that following RFA, out of 928 patients, 46 (5 %) had the recanalization of GSV after a year, and 84 (9 %) patients – after three years. No reliable difference in the clinical effect was observed in patients with SGV diameters, exceeding 16 mm, in both groups after one and three years. We would like to highlight that after three months of observation, the involution of collaterals was achieved in 58 % of patients who had undergone monoablation. In 78 (8.4 %) patients were simultaneously performed radiofrequency ablation with sclerotherapy perforant veins on the shin 3 % solution of polydocanol. In 312 patients, after obliterating the trunk of a large subcutaneous vein performed delayed (after 3 months) minimally invasive operations (mini-phlebectomy, foam ECHO obliteration of perforate veins or their radiofrequency ablation stiletto electrode). Radiofrequency monoablation with delayed ultrasound-guided sclerotherapy is a considerably less traumatic and short-term method compared to simultaneous surgical treatment, which provides for its wide application for elderly patients and people with multimorbid concurrent pathology in the outpatient setting.
References
Gloviczki, P., Comerota, A.J., & Michael, C. (2011). The care of patients with varicose veins and associated chronic venous diseases: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum. J. Vasc. Surg., 53 (5), 2-48. DOI:10.1016/j.jvs.2011.01.079.
Endovascular radiofrequency ablation for varicose veins: An evidence-based analysis. Medical Advisory Secretariat. (2011). Ont Health Technol Assess Ser., 11 (1), 1-93.
Sevil, F., & Colak, A. (2020). The effectiveness of endovenous radiofrequency ablation application in varicose vein diseases of the lower extremity. Cureus., 12 (4),e 7640. DOI: 10.7759/cureus.7640.
Bokeria, L.A., Mikhailichenko, M.V., & Kovalenko, V.I. (2015.) The optimization of surgical treatment of patients with varicose disease of lower extremities. Russian Medical Journal, 21 (1), 10-14.
Hollenbeck, B.K, Hollingsworth, J.M., & Dunn, R.L. (2010). Ambulatory surgery center market share and rates of outpatient surgery in the elderly. Surg. Innov., 2 (4), 340-345. DOI. org/10.1177/1553350610377211.
Khorev, N.G., Sokolov, A.V., & Yelkombayev, М.А. (2019). Radiofrequency ablation and traditional phlebectomy in patients with primary venous disease. Bulletin of Medical Science, 2 (14), 45-49.
Shevchenko, Y.L., & Stojko, J.L. (2013). Basics of clinical phlebology. M.: Shiko.
Shikhmetov, A.N., Lebedev, N.N., & Shafalinov, V.A. (2017). Results of radiofrequency ablation of subcutaneous veins of the lower extremities in hospital-replacement conditions. Herald of the National Medical-Surgical Center N.I. Pirogov, 12 (4), 81-86.
Kayssi, A., Pope, M., & Vucemilo, I. (2015). Endovenous radiofrequency ablation for the treatment of varicose veins. Can. J. Surg., 58 (2), 85-86. DOI: 10.1503/cjs.014914.
Congress of the American West Coast Venous Forum “Challenges and Polemic in Treatment of Venous Pathology” (30 April – 2 May, 2015, Napa, the USA). Novosti Khirurgii, 23 (5), 582-587.
Goshchynsky, V.B., Migenko, B.O., & Svidersky, U.U. (2019). Zastosuvannia PRP ta PRF tekhnolohii u pidhotovtsi do vykonannia radiochastotnoi abliatsii ven u khvorykh na varykoznu khvorobu nyzhnikh kintsivok, uskladnenu trofichnoiu vyrazkoiu [Application of PRP and PRF technologies in preparation for the implantation of radiofrequency vein ablation in patients with varicosity of the lower extremities, trophic ulcer complications]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, 2, 99-104. DOI :I 10.11603/1811-2471.2019.v0.i2.10376 [in Ukrainian].
OliveiraI, R.A., Porto, A.C., & Mazzucca, A.C. (2018). Evidence for varicose vein treatment: an overview of systematic reviews. Sao Paulo Med. J., 136 (4), 324-332. DOI: org/10.1590/1516-3180.2018.0003240418.
Lin, F., Zhang, S., & Sun, Y. (2015). The management of varicose veins. Int. Surg., 100 (1), 185-189. DOI: 10.9738/INTSURG-D-14-00084.1.
Rasmussen, L.H., Lawaetz, M., & Bjoern, L.J. (2011). Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose vein. Br. J. Surg., 98 (8), 1079-1087. DOI: 10.1002/bjs.7555.
Carroll, С., Hummel, S., & Leaviss, J. (2013). Clinical effectiveness and cost-effectiveness of minimally invasive techniques to manage varicose veins: A systematic review and economic evaluation. Health Technol Assess., 17 (48), 1-141. DOI: 10.3310/hta17480.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Hospital Surgery. Journal named by L.Ya. Kovalchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
