Haruta Naoki
Department of Vascular Surgery and Endoscopic Surgery, Takanobashi Central Hospital, Jinyoukai Medical Corporation, Hiroshima, Japan.
Ann Vasc Dis. 2018 Mar 25;11(1):66-71. doi: 10.3400/avd.ra.18-00005.
There were three epoch making events in therapy of varicose veins. The first one is that the endovascular heat ablation (EVHA) using diode laser was authorized by the Ministry of Health Labor and Welfare in January 2011. The second one is that Subfascial Endoscopic Perforator Surgery (SEPS) was also authorized in April 2014. All of the therapies which were covered by the national insurance system had been the procedures for superficial veins but the SEPS is procedure for the perforating veins. The third one is that the foam usage of Polidocasklerol was listed formally at the medical package insert in September 2016. Moreover stub avulsion was introduced as figure-related improvement method with a smaller operation wound instead of conventional varicectomy and the other existing therapies are progressing every day. Therefore, by this education seminar, I lecture mainly on the EVHA, SEPS and foam sclerotherapy in varicose vein treatment. Finally I show one case which you should remember. (This is a translation of Jpn J Vasc Surg 2017; 26: 225-230.).
静脉曲张治疗领域有三项具有里程碑意义的事件。其一,2011年1月,使用二极管激光的血管内热消融术(EVHA)获得厚生劳动省批准。其二,2014年4月,筋膜下内镜交通支静脉离断术(SEPS)也获得批准。此前,所有纳入国家保险体系的治疗方法均针对浅静脉,而SEPS是针对交通支静脉的治疗方法。其三,2016年9月,聚多卡醇泡沫制剂正式列入药品说明书。此外,作为一种与外形改善相关的方法,引入了短段剥脱术,其手术伤口比传统的静脉切除术更小,其他现有治疗方法也在不断发展。因此,在本次教育研讨会上,我将主要讲解静脉曲张治疗中的EVHA、SEPS和泡沫硬化疗法。最后,我展示一个值得大家记住的病例。(本文翻译自《日本血管外科学杂志》2017年;26卷:225 - 230页)