Yu Wenshui, Liu Jing, Yang Hongwei, Wang Zuhui, Xia Yongdi, Liu Peijuan, Zhu Guoxian
Department of Vascular Surgery, The First Affiliated Hospital of ShenZhen University, ShenZhen No.2 Hospital, ShenZhen, 518036, China.
Department of Interventional Radiography, The First Affiliated Hospital of ShenZhen University, ShenZhen No.2 Hospital, ShenZhen, 518036, China.
J Interv Med. 2019 Oct 23;2(4):146-149. doi: 10.1016/j.jimed.2019.10.001. eCollection 2019 Nov.
The aim of this study was to evaluate the clinical effects of the Trivex system in the treatment of primary severe superficial varicose veins of the lower extremity and compare Trivex to the point-form-stripping combined with foam sclerotherapy (FS).
A total of 64 patients (35 females, 29 males; mean age, 57 ± 11 years [range, 29-79 years]) with primary severe superficial varicose veins of the lower extremity involving 64 legs were included between October 2015 and July 2019. The maximum diameter of the vein branches was >20 mm, which appeared to be cystic dilatation and forms large-scale in the crus or the thigh. All patients underwent high ligation and endovenous laser ablation or stripping of the trunk under general anesthesia. The surgical time, pain/phlebitis, number of incisions, amount of bleeding, recurrence of varicose vein, incidence of surgical site infections (SSIs), satisfaction score, and improvement in clinical symptoms were evaluated respectively with the patients in two groups: Group A, with patients who underwent treatment with the Trivex system, and Group B, patients who underwent treatment by point-form-stripping combined with FS.
All procedures were performed successfully. The average operative time in Group A was 56 ± 11 min, whereas that of Group B was 90 ± 33 min, which was a significant difference (p < 0.05). Group A patients felt little pain after surgery, whereas in Group B the level of pain peaked on postoperative day 30, mostly due to thrombophlebitis after FS. There was no recurrence of varicose vein was observed in any patient, however, there were some residual effects in Group B, including the amount of bleeding volume, in-hospital stays, pain/phlebitis, and number of incisions (P < 0.05). There were no significant differences with respect to SSIs, improvement in clinical symptoms, and satisfaction scores observed (p>0.05).
This study shows that patients benefited from both treatment options. However, primary severe superficial varicose veins of the lower extremity treated with the Trivex system suffered less pain with fewer incisions than severe branches treated with the point-form-stripping combined with foam sclerotherapy (FS). In summary, the Trivex system is a suitable treatment prior to point-form-stripping combined with foam sclerotherapy (FS) for those who demand a high level of appearance, and especially for young patients, the Trivex system is recommended.
本研究旨在评估Trivex系统治疗下肢原发性重度浅表静脉曲张的临床效果，并将Trivex系统与点状剥脱联合泡沫硬化疗法（FS）进行比较。
纳入2015年10月至2019年7月期间共64例（女性35例，男性29例；平均年龄57±11岁[范围29 - 79岁]）患有下肢原发性重度浅表静脉曲张且累及64条腿的患者。静脉分支最大直径>20 mm，表现为囊状扩张且在小腿或大腿形成大范围病变。所有患者均在全身麻醉下接受主干高位结扎及腔内激光消融或剥脱术。分别评估两组患者的手术时间、疼痛/静脉炎、切口数量、出血量、静脉曲张复发情况、手术部位感染（SSIs）发生率、满意度评分及临床症状改善情况：A组为接受Trivex系统治疗的患者，B组为接受点状剥脱联合FS治疗的患者。
所有手术均成功完成。A组平均手术时间为56±11分钟，而B组为90±33分钟，差异有统计学意义（p<0.05）。A组患者术后疼痛轻微，而B组疼痛程度在术后第30天达到峰值，主要是由于FS后血栓性静脉炎。所有患者均未观察到静脉曲张复发，但B组在出血量、住院时间、疼痛/静脉炎及切口数量方面存在一些残留影响（P<0.05）。在SSIs、临床症状改善及满意度评分方面未观察到显著差异（p>0.05）。
本研究表明两种治疗方法对患者均有益。然而，与点状剥脱联合泡沫硬化疗法（FS）治疗重度分支相比，Trivex系统治疗下肢原发性重度浅表静脉曲张时疼痛更轻，切口更少。总之，对于对外表要求较高的患者，Trivex系统是点状剥脱联合泡沫硬化疗法（FS）之前的合适治疗方法，尤其对于年轻患者，推荐使用Trivex系统。
