Balint Renata, Farics Akos, Parti Krisztina, Vizsy Laszlo, Batorfi Jozsef, Menyhei Gabor, Balint Istvan B
Faculty of Business and Economics, University of Pannonia, Nagykanizsa, Hungary.
Department of Surgery, Kanizsai Dorottya Hospital, Nagykanizsa, Hungary.
Vascular. 2016 Dec;24(6):649-657. doi: 10.1177/1708538116648035. Epub 2016 Apr 28.
The aim of this review article was to evaluate the long-term technical success rates of the known endovenous ablation procedures in the treatment of the incompetence of the great saphenous vein.
A literature search was conducted in the PubMed-database until the 5 January 2016. All publications with four to five years follow-up were eligible. Meta-analysis was performed by the IVhet-model.
Eight hundred and sixty-two unique publications were found; 17 of them were appropriate for meta-analysis. Overall, 1420 limbs were included in the trial, 939 for endovenous laser ablation, 353 for radiofrequency ablation and 128 for ultrasound guided foam sclerotherapy. Overall, technical success rates were 84.8% for endovenous laser ablation, 88.7% for radiofrequency ablation and 32.8% for ultrasound guided foam sclerotherapy. There were no significant differences between endovenous laser ablation, radiofrequency ablation and ultrasound guided foam sclerotherapy regarding the great saphenous vein reopening (p = 0.66; OR: 0.22; 95% of CI: 0.08-0.62 for radiofrequency ablation vs. endovenous laser ablation; p = 0.96; OR: 0.11; 95% of CI: 0.06-0.20 for endovenous laser ablation vs. ultrasound guided foam sclerotherapy; p = 0.93; OR: 3.20; 95% of CI: 0.54-18.90 for ultrasound guided foam sclerotherapy vs. radiofrequency ablation).
Both endovenous laser ablation and radiofrequency ablation are efficient in great saphenous vein occlusion on the long term. Lacking long-conducted large trials, the efficacy and reliability of ultrasound guided foam sclerotherapy to treat great saphenous vein-reflux is not affirmed.
这篇综述文章的目的是评估已知的静脉内消融手术治疗大隐静脉功能不全的长期技术成功率。
在PubMed数据库中进行文献检索，直至2016年1月5日。所有随访四至五年的出版物均符合条件。采用IVhet模型进行荟萃分析。
共找到862篇独特的出版物；其中17篇适合进行荟萃分析。该试验共纳入1420条肢体，939条接受静脉内激光消融，353条接受射频消融，128条接受超声引导下泡沫硬化疗法。总体而言，静脉内激光消融的技术成功率为84.8%，射频消融的技术成功率为88.7%，超声引导下泡沫硬化疗法的技术成功率为32.8%。在大隐静脉再通方面，静脉内激光消融、射频消融和超声引导下泡沫硬化疗法之间没有显著差异（p = 0.66；OR：0.22；95%CI：0.08 - 0.62，射频消融与静脉内激光消融相比；p = 0.96；OR：0.11；95%CI：0.06 - 0.20，静脉内激光消融与超声引导下泡沫硬化疗法相比；p = 0.93；OR：3.20；95%CI：0.54 - 18.90，超声引导下泡沫硬化疗法与射频消融相比）。
静脉内激光消融和射频消融在长期闭合大隐静脉方面均有效。由于缺乏长期进行的大型试验，超声引导下泡沫硬化疗法治疗大隐静脉反流的疗效和可靠性尚未得到证实。
