The Experts below are selected from a list of 186 Experts worldwide ranked by ideXlab platform
J Brunkwall - One of the best experts on this subject based on the ideXlab platform.
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meta analysis of endovenous radiofrequency obliteration of the great saphenous vein in primary Varicosis
Journal of Endovascular Therapy, 2008Co-Authors: Thomas Luebke, M Gawenda, Joerg Heckenkamp, J BrunkwallAbstract:PURPOSE To compare radiofrequency obliteration (RFO) and conventional surgery with respect to postoperative complications, effectiveness of treatment, and quality of life (QoL). METHODS Several healthcare databases were interrogated to identify all studies published between 1994 and 2007 comparing RFO in primary Varicosis to conventional therapy with vein ligation and stripping. Of 65 articles identified, 8 studies representing 428 patients [224 (52%) endovenous RFO and 204 (48%) stripping] were eligible for the meta-analysis. Adverse events, effectiveness, and QoL outcomes were assessed at several time points up to 2 years. RESULTS There were significant reductions in tenderness and ecchymosis at 1 week and significantly fewer hematomas at 72 hours, 1 week, and 3 weeks associated with RFO. There was no significant difference between the RFO and surgery in immediate or complete great saphenous vein (GSV) occlusion, incomplete GSV closure, freedom from reflux, recurrent varicose veins, recanalization, or neovascularization. QoL results significantly favoring RFO over surgery included return to normal activity and return to work. CONCLUSION It seems that RFO benefits most patients in the short term, but rates of recanalization, re-treatment, occlusion, and reflux may alter with longer follow-up. The lack of such data demonstrates the need for further randomized clinical trials of RFO versus conventional surgery.
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systematic review and meta analysis of endovenous radiofrequency obliteration endovenous laser therapy and foam sclerotherapy for primary Varicosis
Journal of Cardiovascular Surgery, 2008Co-Authors: Thomas Luebke, J BrunkwallAbstract:AIM Radiofrequency obliteration (RFO), endovenous laser therapy (EVLT) and foam sclerotherapy (FS) are potential treatments for varicose veins. A systematic review was undertaken to assess their safety and effectiveness and to compare these endoluminal therapeutic options with conventional ligation and vein stripping. METHODS An electronic health database search was performed on all studies published between 1970 and 2007 describing RFO, EVLT, and FS for treating varicose veins. RESULTS Twenty-nine EVLT studies, 32 RFO studies and 22 FS trials were included. RFO was associated with the worst short and long-term safety and efficacy results compared to EVLT and FS regarding ''complete occlusion at the end of follow-up'', ''phlebitis'', ''deep vein thrombosis'', and ''paraesthesia''. EVLT had the best results concerning the long-term effectiveness parameters for ''occlusion at the end of follow-up'' and ''recanalization, recurrence or development of new veins'', compared to RFO and FS. Foam sclerotherapy of varicose veins is associated with a higher recurrence rate in patients with saphenofemoral incompetence compared to the rates after EVLT or RFO treatment. CONCLUSION EVLT, RFO, and FS seem to be safe and effective modalities with good short and mid-term RESULTS Acquisition of comparative long-term and very long-term data on clinical efficacy (particularly with regard to the formation of recurrent varicose veins), safety, quality of life outcomes and costs is needed by large high-quality prospective randomized trials of endovenous techniques versus each other and versus surgery before considering endovenous techniques as the standard treatment.
Stéphane Avril - One of the best experts on this subject based on the ideXlab platform.
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Finite Element simulation of buckling-induced vein tortuosity and influence of the wall constitutive properties
Journal of the mechanical behavior of biomedical materials, 2013Co-Authors: Pierre Badel, Christian Pierre-yves Rohan, Stéphane AvrilAbstract:The mechanisms giving rise to vein tortuosity, which is often associated with Varicosis, are poorly understood. Recent works suggest that significant biological changes in the wall of varicose veins may precede the mechanical aspects of the disease. To test the hypothesis of tortuosity being a consequence of these changes, a Finite Element model was developed based on previous experimental work on vein buckling. The model was then used to evaluate the effect of alterations of the mechanical behavior of the wall on tortuosity onset and severity. The results showed that increasing anisotropy toward the circumferential direction promotes tortuosity. An increase in wall stiffness tends to decrease the level of tortuosity but interestingly, if the vein segment is little or not pre-stretched such increase will not prevent, or it will even promote, the onset of tortuosity. These results provide additional arguments supporting the hypothesis of tortuosity being the consequence of biologically-induced changes in the varicose vein wall. Based on a 3D model of the leg and in vivo identification of the material properties of varicose veins, a clinical validation of these findings is being developed.
Thomas Luebke - One of the best experts on this subject based on the ideXlab platform.
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meta analysis of endovenous radiofrequency obliteration of the great saphenous vein in primary Varicosis
Journal of Endovascular Therapy, 2008Co-Authors: Thomas Luebke, M Gawenda, Joerg Heckenkamp, J BrunkwallAbstract:PURPOSE To compare radiofrequency obliteration (RFO) and conventional surgery with respect to postoperative complications, effectiveness of treatment, and quality of life (QoL). METHODS Several healthcare databases were interrogated to identify all studies published between 1994 and 2007 comparing RFO in primary Varicosis to conventional therapy with vein ligation and stripping. Of 65 articles identified, 8 studies representing 428 patients [224 (52%) endovenous RFO and 204 (48%) stripping] were eligible for the meta-analysis. Adverse events, effectiveness, and QoL outcomes were assessed at several time points up to 2 years. RESULTS There were significant reductions in tenderness and ecchymosis at 1 week and significantly fewer hematomas at 72 hours, 1 week, and 3 weeks associated with RFO. There was no significant difference between the RFO and surgery in immediate or complete great saphenous vein (GSV) occlusion, incomplete GSV closure, freedom from reflux, recurrent varicose veins, recanalization, or neovascularization. QoL results significantly favoring RFO over surgery included return to normal activity and return to work. CONCLUSION It seems that RFO benefits most patients in the short term, but rates of recanalization, re-treatment, occlusion, and reflux may alter with longer follow-up. The lack of such data demonstrates the need for further randomized clinical trials of RFO versus conventional surgery.
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systematic review and meta analysis of endovenous radiofrequency obliteration endovenous laser therapy and foam sclerotherapy for primary Varicosis
Journal of Cardiovascular Surgery, 2008Co-Authors: Thomas Luebke, J BrunkwallAbstract:AIM Radiofrequency obliteration (RFO), endovenous laser therapy (EVLT) and foam sclerotherapy (FS) are potential treatments for varicose veins. A systematic review was undertaken to assess their safety and effectiveness and to compare these endoluminal therapeutic options with conventional ligation and vein stripping. METHODS An electronic health database search was performed on all studies published between 1970 and 2007 describing RFO, EVLT, and FS for treating varicose veins. RESULTS Twenty-nine EVLT studies, 32 RFO studies and 22 FS trials were included. RFO was associated with the worst short and long-term safety and efficacy results compared to EVLT and FS regarding ''complete occlusion at the end of follow-up'', ''phlebitis'', ''deep vein thrombosis'', and ''paraesthesia''. EVLT had the best results concerning the long-term effectiveness parameters for ''occlusion at the end of follow-up'' and ''recanalization, recurrence or development of new veins'', compared to RFO and FS. Foam sclerotherapy of varicose veins is associated with a higher recurrence rate in patients with saphenofemoral incompetence compared to the rates after EVLT or RFO treatment. CONCLUSION EVLT, RFO, and FS seem to be safe and effective modalities with good short and mid-term RESULTS Acquisition of comparative long-term and very long-term data on clinical efficacy (particularly with regard to the formation of recurrent varicose veins), safety, quality of life outcomes and costs is needed by large high-quality prospective randomized trials of endovenous techniques versus each other and versus surgery before considering endovenous techniques as the standard treatment.
Janchristoph Wollmann - One of the best experts on this subject based on the ideXlab platform.
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duplex ultrasound and efficacy criteria in foam sclerotherapy from the 2nd european consensus meeting on foam sclerotherapy 2006 tegernsee germany
Vasa-european Journal of Vascular Medicine, 2008Co-Authors: Franzxaver Breu, S Guggenbichler, Janchristoph WollmannAbstract:Rationale: The spread of foam sclerotherapy has resulted in the renaissance of sclerotherapy as a non-invasive treatment method for Varicosis. An expanded European expert committee meeting in Tegernsee in April 2006 was prompted by new findings and continuous further development of the method and worked especially on the topics "The role of (duplex) ultrasound in Foam sclerotherapy" and "Evaluation of therapeutic effects of foam Sclerotherapy". It was felt that these criteria are "non-specific" to foam sclerotherapy and would possibly also be suitable for other endovenous ablative procedures. The organisers of the 2nd European Consensus Meeting on foam sclerotherapy (2nd ECMFS) were then asked to publish these recommendations in this separate publication. The entire recommendations of the 2nd ECMFS are published in an extensive overview in this journal (VASA 2008; 37; Supplement 71: 1–32). Methodology: The 29 participants were sent a comprehensive questionnaire in advance covering all the relevant aspects...
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2nd european consensus meeting on foam sclerotherapy 2006 tegernsee germany
Vasa-european Journal of Vascular Medicine, 2008Co-Authors: S Guggenbichler, Janchristoph WollmannAbstract:RATIONALE The spread of Foam Sclerotherapy has resulted in the renaissance of sclerotherapy as a non-invasive treatment method for Varicosis. The use of sclerosant foam for various forms of Varicosis has now become established world-wide as safe and effective. An expanded European expert committee meeting in April 2006, in Tegernsee was prompted by new findings and continuous further development of the method, but also because it had not been possible to consider all the relevant aspects of Foam Sclerotherapy in depth at the first meeting. OBJECTIVES To revise and update the results of the 1st European Consensus Meeting and to include new, important topics in the development of Foam Sclerotherapy. To provide practical information for less experienced colleagues. METHODOLOGY The 29 participants were sent a comprehensive questionnaire in advance covering all the relevant aspects of Foam Sclerotherapy. The organisers drew up various preliminary statements on the basis of the results. During the meeting itself the participants revised and/or approved and/or rejected these statements. An additional analysis of the questionnaire data also enabled preparation of an illustrative description of the broad spectrum of individual procedures used in this form of treatment. RESULTS Foam Sclerotherapy has become an established treatment option for Varicosis and has undoubtedly improved the management of varicose veins. European experts met Tegernsee for a second time to revise and expand their previous recommendations. In addition, individual working groups focused extensively on important issues. The current consensus, recommendations and descriptions of the individual aspects of the methods concern such issues as the indications for Foam Sclerotherapy, concentration and volume of the liquid sclerosants, relative and absolute contraindications, access and puncture options as well as clinical and ultrasound-guided recording of the treatment results. This final document reflects the experts' opinions on the principles of the effective and, above all, safe use of sclerosant foam for various indications and correct monitoring of the results of Foam Sclerotherapy.
Pierre Badel - One of the best experts on this subject based on the ideXlab platform.
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Finite Element simulation of buckling-induced vein tortuosity and influence of the wall constitutive properties
Journal of the mechanical behavior of biomedical materials, 2013Co-Authors: Pierre Badel, Christian Pierre-yves Rohan, Stéphane AvrilAbstract:The mechanisms giving rise to vein tortuosity, which is often associated with Varicosis, are poorly understood. Recent works suggest that significant biological changes in the wall of varicose veins may precede the mechanical aspects of the disease. To test the hypothesis of tortuosity being a consequence of these changes, a Finite Element model was developed based on previous experimental work on vein buckling. The model was then used to evaluate the effect of alterations of the mechanical behavior of the wall on tortuosity onset and severity. The results showed that increasing anisotropy toward the circumferential direction promotes tortuosity. An increase in wall stiffness tends to decrease the level of tortuosity but interestingly, if the vein segment is little or not pre-stretched such increase will not prevent, or it will even promote, the onset of tortuosity. These results provide additional arguments supporting the hypothesis of tortuosity being the consequence of biologically-induced changes in the varicose vein wall. Based on a 3D model of the leg and in vivo identification of the material properties of varicose veins, a clinical validation of these findings is being developed.
