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Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study

BACKGROUND: In endovenous laser ablation (EVLA), the great saphenous vein (GSV) is usually ablated from the knee to the groin, with no treatment of the below-knee segment regardless of its reflux status. However, persistent below-knee GSV reflux appears to be responsible for residual varicosities an...

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Autores principales: de Araujo, Walter Junior Boim, Timi, Jorge Rufino Ribas, Nejm, Carlos Seme, Erzinger, Fabiano Luiz, Caron, Filipe Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829704/
https://www.ncbi.nlm.nih.gov/pubmed/29930575
http://dx.doi.org/10.1590/1677-5449.001516
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author de Araujo, Walter Junior Boim
Timi, Jorge Rufino Ribas
Nejm, Carlos Seme
Erzinger, Fabiano Luiz
Caron, Filipe Carlos
author_facet de Araujo, Walter Junior Boim
Timi, Jorge Rufino Ribas
Nejm, Carlos Seme
Erzinger, Fabiano Luiz
Caron, Filipe Carlos
author_sort de Araujo, Walter Junior Boim
collection PubMed
description BACKGROUND: In endovenous laser ablation (EVLA), the great saphenous vein (GSV) is usually ablated from the knee to the groin, with no treatment of the below-knee segment regardless of its reflux status. However, persistent below-knee GSV reflux appears to be responsible for residual varicosities and symptoms of venous disease. OBJECTIVES: To evaluate clinical and duplex ultrasound (DUS) outcomes of the below-knee segment of the GSV after above-knee EVLA associated with conventional surgical treatment of varicosities and incompetent perforating veins. METHODS: Thirty-six patients (59 GSVs) were distributed into 2 groups, a control group (26 GSVs with normal below-knee flow on DUS) and a test group (33 GSVs with below-knee reflux). Above-knee EVLA was performed with a 1470-nm bare-fiber diode laser and supplemented with phlebectomies of varicose tributaries and insufficient perforating-communicating veins through mini-incisions. Follow-up DUS, clinical evaluation using the venous clinical severity score (VCSS), and evaluation of complications were performed at 3-5 days after the procedure and at 1, 6, and 12 months. RESULTS: Mean patient age was 45 years, and 31 patients were women (86.12%). VCSS improved in both groups. Most patients in the test group exhibited normalization of reflux, with normal flow at the beginning of follow-up (88.33% of GSVs at 3-5 days and 70% at 1 month). However, in many of these patients reflux eventually returned (56.67% of GSVs at 6 months and 70% at 1 year). CONCLUSIONS: These data suggest that reflux in the below-knee segment of the GSV was not influenced by the treatment performed.
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spelling pubmed-58297042018-06-21 Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study de Araujo, Walter Junior Boim Timi, Jorge Rufino Ribas Nejm, Carlos Seme Erzinger, Fabiano Luiz Caron, Filipe Carlos J Vasc Bras Original Article BACKGROUND: In endovenous laser ablation (EVLA), the great saphenous vein (GSV) is usually ablated from the knee to the groin, with no treatment of the below-knee segment regardless of its reflux status. However, persistent below-knee GSV reflux appears to be responsible for residual varicosities and symptoms of venous disease. OBJECTIVES: To evaluate clinical and duplex ultrasound (DUS) outcomes of the below-knee segment of the GSV after above-knee EVLA associated with conventional surgical treatment of varicosities and incompetent perforating veins. METHODS: Thirty-six patients (59 GSVs) were distributed into 2 groups, a control group (26 GSVs with normal below-knee flow on DUS) and a test group (33 GSVs with below-knee reflux). Above-knee EVLA was performed with a 1470-nm bare-fiber diode laser and supplemented with phlebectomies of varicose tributaries and insufficient perforating-communicating veins through mini-incisions. Follow-up DUS, clinical evaluation using the venous clinical severity score (VCSS), and evaluation of complications were performed at 3-5 days after the procedure and at 1, 6, and 12 months. RESULTS: Mean patient age was 45 years, and 31 patients were women (86.12%). VCSS improved in both groups. Most patients in the test group exhibited normalization of reflux, with normal flow at the beginning of follow-up (88.33% of GSVs at 3-5 days and 70% at 1 month). However, in many of these patients reflux eventually returned (56.67% of GSVs at 6 months and 70% at 1 year). CONCLUSIONS: These data suggest that reflux in the below-knee segment of the GSV was not influenced by the treatment performed. Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2016 /pmc/articles/PMC5829704/ /pubmed/29930575 http://dx.doi.org/10.1590/1677-5449.001516 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
de Araujo, Walter Junior Boim
Timi, Jorge Rufino Ribas
Nejm, Carlos Seme
Erzinger, Fabiano Luiz
Caron, Filipe Carlos
Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
title Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
title_full Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
title_fullStr Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
title_full_unstemmed Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
title_short Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
title_sort persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829704/
https://www.ncbi.nlm.nih.gov/pubmed/29930575
http://dx.doi.org/10.1590/1677-5449.001516
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