Papers reviewed in September 2015

Posted on by Mike

Shadid N et al
Predictors of recurrence of great saphenous vein reflux following treatment with ultrasound-guided foamsclerotherapy.
Phlebology. 2015 Apr;30(3):194-9.

Objective: To investigate which clinical characteristics at baseline are predictive for great saphenous vein recurrence following ultrasound-guided foamsclerotherapy.
Materials and Methods: Data of patients treated for great saphenous vein incompetence with ultrasound-guided foamsclerotherapy were derived from a multicentre prospective randomized controlled trial comparing surgery versus ultrasound-guided foamsclerotherapy with a follow-up of two years. Recurrence of reflux was determined on colour duplex scans at three months, one year and two years. Univariate and multivariate Cox regression analysis was used to evaluate the effect of gender, age, C of CEAP classification, diameter of great saphenous vein, injected foam volume, presence of distal great saphenous vein reflux, presence of reflux in the anterior accessory saphenous vein and Venous Clinical Severity Score on risk of recurrent reflux.
Results: Two hundred twenty-five patients were available for analysis. Treatment after one single session was successful in 120 patients and recurrence of saphenous reflux was observed in 105 patients within two years during follow-up. Significant associations with risk of recurrence were observed for mid thigh great saphenous vein diameter (HR?=?1.012 with 95% CI: 1.002-1.022, p?=?0.022) and presence of distal great saphenous vein reflux (HR?=?1.882 with 95% CI: 1.029-3.443, p?=?0.040).
Conclusion: In conclusion, this prospective study suggests that ultrasound-guided foamsclerotherapy treatment for the proximal great saphenous vein is less effective for patients with a large vein and a refluxing distal great saphenous vein at baseline.

 

Lane TRA et al
Retrograde inversion stripping as a complication of the ClariVein mechanochemical venous ablation procedure.
Ann R Coll Surg Engl. 2015 Mar; 97(2): 18-20

The endovenous revolution has accelerated the development of new techniques and devices for the treatment of varicose veins. The ClariVein mechanochemical ablation device offers tumescentless treatment with a rotating ablation tip that can theoretically become stuck in tissue. We present the first report of retrograde stripping of the small saphenous vein without anaesthesia following attempted use of the ClariVein device, without adverse sequelae.

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