Pavlović Miloš D, Schuller-Petrović Sanja, Pichot Olivier, Rabe Eberhard, Maurins Uldis, Morrison Nick, Pannier Felizitas
Dermatology Centre Parmova & DCP-Venex Centre, Ljubljana, Slovenia.
VENEX Vein Centre, Vienna, Austria
Phlebology. 2015 May;30(4):257-73. doi: 10.1177/0268355514524568. Epub 2014 Feb 17.
Endovenous thermal ablation (ETA) procedures are catheter-directed, ultrasound (US)-guided thermal methods for treatment in varicose veins disease. Radiofrequency, laser or steam energy thermally denatures vein wall collagen, leading first to vein wall inflammation, then fibrosis and finally to occlusion. The aim of this guideline is to give evidence-based recommendations for ETA procedures.
These guidelines were drafted during a consensus meeting of a group of experts in the field of ETA in June 2012 (Hvar, Croatia) under the auspices of the International Union of Phlebology (IUP). These guidelines review the present state of knowledge as reflected in peer-reviewed published medical literature. The recommendations of these guidelines are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines.
Recommendations on the use of ETA procedures were made based on the quality of evidence for efficacy, safety, tolerability, cosmetic outcome, patient satisfaction/preference and, where appropriate, on the experts' opinion. Health economics were not considered, since differences in national health systems and pricing make it difficult to form general conclusions that are relevant at an international level.
静脉内热消融（ETA）手术是一种在超声（US）引导下，通过导管进行的治疗静脉曲张疾病的热疗方法。射频、激光或蒸汽能量使静脉壁胶原蛋白发生热变性，首先导致静脉壁炎症，接着是纤维化，最终形成闭塞。本指南的目的是为ETA手术提供基于证据的建议。
这些指南于2012年6月在国际静脉学联盟（IUP）的支持下，由ETA领域的一组专家在克罗地亚赫瓦尔召开的共识会议期间起草。这些指南回顾了同行评审发表的医学文献中所反映的当前知识状态。这些指南的建议根据美国胸科医师学会临床实践指南推荐强度和证据质量分级工作组的建议进行分级。
基于疗效、安全性、耐受性、美容效果、患者满意度/偏好的证据质量，并在适当情况下参考专家意见，对ETA手术的使用提出了建议。未考虑卫生经济学因素，因为各国卫生系统和定价的差异使得难以形成在国际层面具有相关性的一般性结论。
