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Karen L. Beasley - One of the best experts on this subject based on the ideXlab platform.
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Comparative outcomes of different endovenous thermal ablation systems on great and Small Saphenous Vein insufficiency: Long-term results
Lasers in surgery and medicine, 2015Co-Authors: Robert A. Weiss, Margaret A. Weiss, Sasima Eimpunth, Sandra Wheeler, Suthipol Udompunturak, Karen L. BeasleyAbstract:Background and Objective This study examined the outcomes of over a decade of endovenous thermal ablation (EVTA) treatments for great and Small Saphenous Vein (GSV and SSV) insufficiency, utilizing three different endovenous thermal ablation systems. Materials and Methods This retrospective study reviewed EVTA treatments performed at an outpatient clinic (MDLSVI) from April 1999 to February 2013. Systems included 810 nm diode (hemoglobin targeting), 1,320 nm laser (water targeting) and a radiofrequency (direct thermal transfer) (RF) device. Clinical and ultrasonographic evaluation were performed before treatment and at each follow-up visit. Patients were examined yearly by Duplex ultrasonography. Success was defined as complete absence of reflux. Results Analysis of 934 treatments demonstrated that although recanalization could occur over time, endovenous ablation has a very high success rate. Ablation rates were 92.5%, 85.9%, and 71.9% at 6-months, 1-year, and 5-years after procedures. Recanalization occurred in 156 out of 934 treatments (16.7%) during the follow-up period. Among three difference systems, the total ablation success rate was significantly different (P
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comparative outcomes of different endovenous thermal ablation systems on great and Small Saphenous Vein insufficiency long term results
Lasers in Surgery and Medicine, 2015Co-Authors: Robert A. Weiss, Margaret A. Weiss, Sasima Eimpunth, Sandra Wheeler, Suthipol Udompunturak, Karen L. BeasleyAbstract:Background and Objective This study examined the outcomes of over a decade of endovenous thermal ablation (EVTA) treatments for great and Small Saphenous Vein (GSV and SSV) insufficiency, utilizing three different endovenous thermal ablation systems. Materials and Methods This retrospective study reviewed EVTA treatments performed at an outpatient clinic (MDLSVI) from April 1999 to February 2013. Systems included 810 nm diode (hemoglobin targeting), 1,320 nm laser (water targeting) and a radiofrequency (direct thermal transfer) (RF) device. Clinical and ultrasonographic evaluation were performed before treatment and at each follow-up visit. Patients were examined yearly by Duplex ultrasonography. Success was defined as complete absence of reflux. Results Analysis of 934 treatments demonstrated that although recanalization could occur over time, endovenous ablation has a very high success rate. Ablation rates were 92.5%, 85.9%, and 71.9% at 6-months, 1-year, and 5-years after procedures. Recanalization occurred in 156 out of 934 treatments (16.7%) during the follow-up period. Among three difference systems, the total ablation success rate was significantly different (P < 0.001). The 1,320 nm Nd:YAG laser (n = 502) provided the highest ablation rate compared to the radiofrequency (n = 398) and 810 nm diode (n = 34) throughout their follow-up period, which were 8, 13, and 9 years, respectively. At 1-year follow-up, successful ablation rates of RF, 810 nm, and 1,320 nm were 78.2%, 80.8%, and 93.7%, respectively. At 5-year follow-up, successful ablation rates of RF, 810 nm, and 1,320 nm were 61.7%, 65.7%, and 84.7%, respectively. Conclusion EVTA is very effective for ablation of the GSV and SSV. Complete ablation varied significantly among different systems with water targeting 1,320 nm providing the highest incidence Saphenous Vein ablation. This remained durable at 8-year follow-up by Duplex ultrasound. Lasers Surg. Med. 47:156–160, 2015. © 2015 Wiley Periodicals, Inc.
Robert A. Weiss - One of the best experts on this subject based on the ideXlab platform.
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Comparative outcomes of different endovenous thermal ablation systems on great and Small Saphenous Vein insufficiency: Long-term results
Lasers in surgery and medicine, 2015Co-Authors: Robert A. Weiss, Margaret A. Weiss, Sasima Eimpunth, Sandra Wheeler, Suthipol Udompunturak, Karen L. BeasleyAbstract:Background and Objective This study examined the outcomes of over a decade of endovenous thermal ablation (EVTA) treatments for great and Small Saphenous Vein (GSV and SSV) insufficiency, utilizing three different endovenous thermal ablation systems. Materials and Methods This retrospective study reviewed EVTA treatments performed at an outpatient clinic (MDLSVI) from April 1999 to February 2013. Systems included 810 nm diode (hemoglobin targeting), 1,320 nm laser (water targeting) and a radiofrequency (direct thermal transfer) (RF) device. Clinical and ultrasonographic evaluation were performed before treatment and at each follow-up visit. Patients were examined yearly by Duplex ultrasonography. Success was defined as complete absence of reflux. Results Analysis of 934 treatments demonstrated that although recanalization could occur over time, endovenous ablation has a very high success rate. Ablation rates were 92.5%, 85.9%, and 71.9% at 6-months, 1-year, and 5-years after procedures. Recanalization occurred in 156 out of 934 treatments (16.7%) during the follow-up period. Among three difference systems, the total ablation success rate was significantly different (P
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comparative outcomes of different endovenous thermal ablation systems on great and Small Saphenous Vein insufficiency long term results
Lasers in Surgery and Medicine, 2015Co-Authors: Robert A. Weiss, Margaret A. Weiss, Sasima Eimpunth, Sandra Wheeler, Suthipol Udompunturak, Karen L. BeasleyAbstract:Background and Objective This study examined the outcomes of over a decade of endovenous thermal ablation (EVTA) treatments for great and Small Saphenous Vein (GSV and SSV) insufficiency, utilizing three different endovenous thermal ablation systems. Materials and Methods This retrospective study reviewed EVTA treatments performed at an outpatient clinic (MDLSVI) from April 1999 to February 2013. Systems included 810 nm diode (hemoglobin targeting), 1,320 nm laser (water targeting) and a radiofrequency (direct thermal transfer) (RF) device. Clinical and ultrasonographic evaluation were performed before treatment and at each follow-up visit. Patients were examined yearly by Duplex ultrasonography. Success was defined as complete absence of reflux. Results Analysis of 934 treatments demonstrated that although recanalization could occur over time, endovenous ablation has a very high success rate. Ablation rates were 92.5%, 85.9%, and 71.9% at 6-months, 1-year, and 5-years after procedures. Recanalization occurred in 156 out of 934 treatments (16.7%) during the follow-up period. Among three difference systems, the total ablation success rate was significantly different (P < 0.001). The 1,320 nm Nd:YAG laser (n = 502) provided the highest ablation rate compared to the radiofrequency (n = 398) and 810 nm diode (n = 34) throughout their follow-up period, which were 8, 13, and 9 years, respectively. At 1-year follow-up, successful ablation rates of RF, 810 nm, and 1,320 nm were 78.2%, 80.8%, and 93.7%, respectively. At 5-year follow-up, successful ablation rates of RF, 810 nm, and 1,320 nm were 61.7%, 65.7%, and 84.7%, respectively. Conclusion EVTA is very effective for ablation of the GSV and SSV. Complete ablation varied significantly among different systems with water targeting 1,320 nm providing the highest incidence Saphenous Vein ablation. This remained durable at 8-year follow-up by Duplex ultrasound. Lasers Surg. Med. 47:156–160, 2015. © 2015 Wiley Periodicals, Inc.
Carlo Martinoli - One of the best experts on this subject based on the ideXlab platform.
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neurophysiological and ultrasound findings in sural nerve lesions following stripping of the Small Saphenous Vein
Muscle & Nerve, 1999Co-Authors: Stefano Simonetti, Stefano Bianchi, Carlo MartinoliAbstract:We describe the neurophysiological and ultrasound (US) findings in two patients with right sural nerve lesions following stripping of the Small Saphenous Vein for varicose Vein treatment. In the first case, US showed a tear of the nerve proximal to the lateral malleolus and a hypoechoic swelling of the proximal stump, likely related to a terminal bulb neuroma. A sural conduction study performed distally and proximally to the lesion through a near-nerve needle technique showed absent responses. In the second case, US showed a deep subcutaneous extension of a postsurgical scar placed behind the lateral malleolus close to the sural nerve, but no nerve discontinuity. Sural conduction study showed absent responses distal to the scar. Sural stimulation immediately above the scar yielded a Small response at the sciatic nerve. A subsequent investigation performed 15 months after the operation showed absent proximal and distal responses. The combination of US and sural conduction study, including recording at the sciatic nerve, to our knowledge has not been described previously, and may yield important complementary information in the diagnosis of sural nerve lesions. © 1999 John Wiley & Sons, Inc. Muscle Nerve 22: 1724–1726, 1999
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Neurophysiological and ultrasound findings in sural nerve lesions following stripping of the Small Saphenous Vein.
Muscle & nerve, 1999Co-Authors: Stefano Simonetti, Stefano Bianchi, Carlo MartinoliAbstract:We describe the neurophysiological and ultrasound (US) findings in two patients with right sural nerve lesions following stripping of the Small Saphenous Vein for varicose Vein treatment. In the first case, US showed a tear of the nerve proximal to the lateral malleolus and a hypoechoic swelling of the proximal stump, likely related to a terminal bulb neuroma. A sural conduction study performed distally and proximally to the lesion through a near-nerve needle technique showed absent responses. In the second case, US showed a deep subcutaneous extension of a postsurgical scar placed behind the lateral malleolus close to the sural nerve, but no nerve discontinuity. Sural conduction study showed absent responses distal to the scar. Sural stimulation immediately above the scar yielded a Small response at the sciatic nerve. A subsequent investigation performed 15 months after the operation showed absent proximal and distal responses. The combination of US and sural conduction study, including recording at the sciatic nerve, to our knowledge has not been described previously, and may yield important complementary information in the diagnosis of sural nerve lesions.
Xu Qinghua - One of the best experts on this subject based on the ideXlab platform.
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Transcatheter thrombolysis via the Small Saphenous Vein for deep venous thrombosis of lower limb
Journal of Interventional Radiology, 2010Co-Authors: Jiang Zhongming, Xu QinghuaAbstract:Objective To discuss the clinical value of transcatheter thrombolysis via the Small Saphenous Vein for the treatment of deep venous thrombosis(DVT)of lower extremity.Methods Angiography of the diseased lower limb was performed in 14 patients with suspected DVT of lower limb.When the diagnosis was confirmed,the catheter-directed thrombolosis via the Small Saphenous Vein was carried out through continuous infusion of urokinase with a micro-pump.The clinical symptoms were observed and the therapeutic results were analyzed.Results Of 14 cases with lower extremity DVT,central type DVT was seen in 8 and mixed type in 6.The total success rate of thrombolysis was 71.4%.Trunk re-canalization as well as increased collateral circulation was seen in 10 patients.Alleviation of pain,subsidence of swelling and restoring to normal labor were obtained in 12 patients.Significant subsidence of edema was achieved in the remaining 2 patients and the patients were able to do some household works.Conclusion The catheter-directed thrombolysis via the Small Saphenous Vein is a safe and effective treatment for lower extremity DVT.(J Intervent Radiol,2010,19: 944-946)
Arie C. Van Der Ham - One of the best experts on this subject based on the ideXlab platform.
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Endovenous laser ablation versus conventional surgery in the treatment of Small Saphenous Vein incompetence
Journal of vascular surgery. Venous and lymphatic disorders, 2013Co-Authors: Avinash D. Roopram, May Y. Lind, Jerome P. Van Brussel, Liesbeth C. Terlouw-punt, Erwin Birnie, André A.e.a. De Smet, Arie C. Van Der HamAbstract:Introduction In this multicenter, randomized controlled trial, endovenous laser ablation (EVLA) is compared with conventional surgery for the treatment of varicose Veins based on incompetence of the Small Saphenous Vein and the saphenopopliteal junction (SPJ). Methods In two Dutch hospitals, 189 patients were enrolled and randomized to receive EVLA (810-nm laser) or ligation of the SPJ. End points were success rate measured with duplex ultrasound (6 weeks post-treatment), perioperative pain, quality of life, duration of surgery, difficulty of surgery, complications, cosmetic results, and number of days to resume work and normal activities. Pain was measured on a visual analog scale (VAS). Quality of life was assessed using the Aberdeen Varicose Vein Questionnaire (AVVQ) and Euro Qol-5D. The follow-up duration in this article is 6 weeks. Results One hundred seventy-five patients have been treated and analyzed. One hundred eighteen patients (67%) underwent EVLA, and 57 patients (33%) underwent ligation of the SPJ. The patient characteristics were similar in both groups. In the surgery group, 21% residual incompetence of the SPJ was seen after 6 weeks, compared with 0.9% in the laser group. Both treatment modalities reduced pain after 6 weeks. One week post-treatment, patients in the EVLA group temporarily experienced more pain compared with the surgery group (31 vs 18 on a VAS from 0 to 100). There were no significant differences between the two groups with respect to quality of life. Both treatments did show improvement in quality of life. Also with regard to the cosmetics, there were no differences, aside from the fact that patients rated their scar as more beautiful after EVLA. After EVLA, patients could return to work more quickly. The operation time was longer in the surgery group. After 2 weeks, there were significantly more neurological complications in the surgery group: 18 (31%) vs 16 (17%) patients in the EVLA group. Ten percent of patients in the surgery group developed a surgical site infection vs 0% in the EVLA group. Conclusions EVLA provides an excellent alternative to conventional surgery in the treatment of symptomatic varicose Veins due to an incompetent Small Saphenous Vein with SPJ. EVLA has a superior immediate success rate, is easier and faster, and has fewer complications.
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The surgical anatomy of the Small Saphenous Vein and adjacent nerves in relation to endovenous thermal ablation
Journal of vascular surgery, 2012Co-Authors: Arie C. Van Der Ham, A. Kerver, Hilco P. Theeuwes, Paul H. C. Eilers, Alex Poublon, Gert-jan KleinrensinkAbstract:Background Thermal damage to peripheral nerves is a known complication of endovenous thermal ablation (EVA) of the Small Saphenous Vein (SSV). Therefore, the main objective of this anatomic study was to define a safe zone in the lower leg where EVA of the SSV can be performed safely. Methods The anatomy of the SSV and adjacent nerves was studied in 20 embalmed human specimens. The absolute distances between the SSV and the sural nerve (SN) (closest/nearest branch) were measured over the complete length of the leg (>120 data points per leg), and the presence of the interlaying deep fascia was mapped. The distance between the SSV and the tibial nerve (TN) and the common peroneal nerve was assessed. A new analysis method, computer-assisted surgical anatomy mapping, was used to visualize the gathered data. Results The distance between the SSV and the SN was highly variable. In the proximal one-third of the lower leg, the distance between the Vein and the nerve was Conclusions At the saphenopopliteal region, the TN is at risk during EVA. In the distal two-thirds of the lower leg, the SN is at risk for (thermal) damage due to the Small distance to the SSV and the absence of the deep fascia between both structures. The proximal one-third of the lower leg is the optimal region for EVA of the SSV to avoid nerve damage; the fascia between the SSV and the SN is a natural barrier in this region that could preclude (thermal) damage to the nerve.