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静脉直径、肥胖与机械化学消融后再通率。

Vein diameter, obesity, and rates of recanalization after mechanochemical ablation.

机构信息

Emory University School of Medicine, Atlanta, GA.

Department of Surgery, Emory University School of Medicine, Atlanta, GA.

出版信息

J Vasc Surg Venous Lymphat Disord. 2024 Nov;12(6):101935. doi: 10.1016/j.jvsv.2024.101935. Epub 2024 Jun 28.

Abstract

OBJECTIVE

A large vein diameter is associated with higher recanalization rates after endovenous thermal ablation procedures of the great saphenous vein (GSV) and small saphenous vein (SSV). However, relatively few studies have explored the relationship between vein diameter and recanalization rates after mechanochemical ablation (MOCA).

METHODS

We conducted a retrospective review of patients with chronic venous insufficiency who underwent MOCA of the GSV or SSV from 2017 to 2021 at a single hospital. Patients with no follow-up ultrasound examination were excluded. Patients were classified as having a large (≥1 cm) or small (<1 cm) treated vein. The primary outcomes were 2-year recanalization and reintervention of the treated segment.

RESULTS

A total of 186 MOCA procedures during the study period were analyzed. There was no differences in age, gender, history of venous thromboembolic events, use of anticoagulation, obesity, or length of treated segment between the cohorts. Patients with large veins were less likely to have stasis ulcers compared with those with small veins (3.2% vs 21.5%; P < .05 on Fisher exact test). Patients with large veins had a higher incidence of postoperative local complications (24.2% vs 7.2%, P < .05 on χ test). A survival analysis with Cox proportional hazards showed no significant difference in recanalization rates with larger vein diameters. However, obesity was found to correlate significantly with recanalization.

CONCLUSIONS

A large vein diameter was not associated with higher recanalization rates after MOCA of the GSVs and SSVs. However, obesity was found to correlate with recanalization rates.

摘要

目的

大静脉直径与腔内热消融治疗大隐静脉(GSV)和小隐静脉(SSV)后的再通率较高相关。然而,很少有研究探讨机械化学消融(MOCA)后静脉直径与再通率之间的关系。

方法

我们对 2017 年至 2021 年期间在一家医院接受 MOCA 治疗的慢性静脉功能不全患者进行了回顾性研究。排除了没有随访超声检查的患者。将患者分为治疗静脉直径较大(≥1cm)或较小(<1cm)。主要结局是治疗节段 2 年再通和再干预。

结果

在研究期间共分析了 186 例 MOCA 手术。两组在年龄、性别、静脉血栓栓塞事件史、抗凝使用、肥胖或治疗节段长度方面无差异。与小静脉相比,大静脉患者更不易发生淤滞性溃疡(3.2% vs 21.5%;Fisher 确切检验,P<0.05)。大静脉患者术后局部并发症发生率较高(24.2% vs 7.2%,X 检验,P<0.05)。Cox 比例风险生存分析显示,较大静脉直径与再通率无显著差异。然而,肥胖与再通率显著相关。

结论

在 GSVs 和 SSVs 的 MOCA 治疗后,大静脉直径与再通率无显著相关性。然而,肥胖与再通率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9776/11523410/d616f4b8f8ea/gr1.jpg

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