Guven Hakan
Department of Cardiovascular Surgery, Heart an Arrythmia Hospital, Bursa, Türkiye.
Vascular. 2025 Feb;33(1):174-181. doi: 10.1177/17085381241236927. Epub 2024 Feb 27.
Chronic venous insufficiency is mainly caused by reflux, obstruction, or both. Endovenous glue ablation has become one of the widely used methods for treating reflux in recent years. Duplex ultrasonography is the most commonly used method for diagnosing and evaluating treatment. However, there is important information that plethysmographic venous hemodynamics provides, which Duplex USG cannot provide. This retrospective study aimed to evaluate the 5-year clinical, anatomical, and hemodynamic results of endovenous glue ablation in the treatment of chronic venous insufficience, accompanied by the data from the plethysmographic study.
Between January 2018 and August 2018, 133 patients with symptomatic CEAP 2-6 varicose veins with reflux of the great saphenous vein lasting longer than 0.5 seconds and a diameter of 5.5 mm in the standing great saphenous vein underwent EVGA. CEAP, VCSS, CIVIQ 20, Doppler USG, GSV diameters and insufficiency times, and hemodynamically Venous Refilling Time and Venous Half-Value Time measurements were performed before the procedure. In the same way, measurements were made at the 1st, 3rd, 6th, 12th, 24th, and 60th months of the patients who were called and came to the postoperative follow-up.
Procedural success was 100%, and complete occlusion was observed %93 after treatment, at the 60 month. The improvement in VCSS (from 4.4 ± 1.3 to 1.7 ± 0.9), CIVIQ20 (from 8.5 ± 3.1 to 4.7 ± 2.0), VRT (from 20.3 ± 5.0 to 131.1 ± 4.0), and TH (from 2.8 ± 0.3 to 2.4 ± 0.2) was significant ( < .001 was for all).
Endovenous glue ablation is a preferred method for the treatment of great saphenous vein insufficiency due to its ease of use and the comfort it provides to patients, as well as its effectiveness and safety. In particular, it can be considered an effective method for improving venous hemodynamics and relieving associated symptoms.
慢性静脉功能不全主要由反流、阻塞或两者共同引起。近年来,静脉内胶水消融已成为治疗反流的广泛应用方法之一。双功超声检查是诊断和评估治疗最常用的方法。然而,体积描记法静脉血流动力学提供了双功超声检查无法提供的重要信息。本回顾性研究旨在评估静脉内胶水消融治疗慢性静脉功能不全的5年临床、解剖和血流动力学结果,并结合体积描记法研究的数据。
2018年1月至2018年8月,133例有症状的CEAP 2-6级大隐静脉曲张患者,大隐静脉反流持续时间超过0.5秒,站立位大隐静脉直径5.5毫米,接受了静脉内胶水消融术(EVGA)。术前进行CEAP、VCSS、CIVIQ 20、多普勒超声检查、大隐静脉直径和反流时间测量,以及血流动力学静脉充盈时间和静脉半值时间测量。同样,对术后随访前来的患者在第1、3、6、12、24和60个月进行测量。
手术成功率为100%,治疗后60个月观察到完全闭塞率为93%。VCSS(从4.4±1.3降至1.7±0.9)、CIVIQ20(从8.5±3.1降至4.7±2.0)、VRT(从20.3±5.0升至131.1±4.0)和TH(从2.8±0.3降至2.4±0.2)的改善具有显著性(所有P均<0.001)。
静脉内胶水消融术因其使用方便、给患者带来舒适感以及有效性和安全性,是治疗大隐静脉功能不全的首选方法。特别是,它可被认为是改善静脉血流动力学和缓解相关症状的有效方法。