在动物模型中，使用VELEX导管的空静脉消融技术、静脉内激光消融和泡沫硬化疗法比较静脉壁效应。
Comparing venous wall effects using the empty vein ablation technique with VELEX catheter, endovenous laser ablation and foam sclerotherapy in an animal model.
作者信息
Salerno Mario, Bissacco Daniele, Chi Yung-Wei, Narayanan Sriram, Addis Alessandro, Martelli Fabio, Zaccagnini Germana, Aloi Teresa Lucia, Nano Giovanni, Gianesini Sergio, Righini Paolo
机构信息
Unit of Angiology, Department of Medicine and Cardiopulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Tradate, Varese, Italy; I-VASC S.r.l, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
出版信息
J Vasc Surg Venous Lymphat Disord. 2025 Apr 23;13(5):102251. doi: 10.1016/j.jvsv.2025.102251.
OBJECTIVE
To describe residual intima and the average media thickness persisted after the empty vein ablation (EVA) technique, endovenous laser ablation (EVLA), and foam sclerotherapy (FS) in a sheep in vivo model.
METHODS
Six iliofemoral and two jugular sheep vein axes were treated as follows: four with EVA (using polidocanol [POL] 0.5% or 1% with 1 or 3 minutes as contact time), two with FS (FS-1 and FS during Valsalva maneuver [FS-Val], POL1% for 10 minutes), and two with EVLA (1470 nm radial, 80 J/cm).
RESULTS
The average percentage of residual intima layer was 2% (interquartile range [IQR]: 1%-4%) for EVA-POL0.5%-1 minute, 1% (IQR: 0%-3.5%) for EVA-POL0.5%-3 minutes, 2% (IQR: 0%-4%) for EVA-POL1%-1 minute, 0 for EVA-POL1%-3 minutes, 13% (IQR: 13%-15.7%) for FS, 1% (IQR: 0%-3%) for FS-Val, and 1% (IQR: 0%-6%) for EVLA. The average percentage of residual media thickness was 13% (IQR: 8%-15%) for EVA-POL0.5%-1 minute, 6% (IQR: 4%-9%) for EVA-POL0.5%-3 minutes, 13% (IQR: 10%-27%) for EVA-POL1%-1 minute, 6% (IQR: 5%-12%) for EVA-POL1%-3 minutes, 51% (IQR: 40%-62%) for FS, 29% (IQR: 23%-35%) for FS-Val, and 62% (IQR: 41%-75%) for EVLA.
CONCLUSIONS
EVA demonstrated better results in vein wall damage compared with EVLA and FS, both in intima and media layers.
CLINICAL RELEVANCE
This study provides crucial insights into the effectiveness of different vein treatment techniques, particularly the empty vein ablation method, in minimizing residual intima and media thickness. By evaluating these outcomes in a sheep model, it highlights how empty vein ablation may lead to more vein wall damage compared with endovenous laser ablation and foam sclerotherapy. For clinicians, understanding the comparative efficacy of these treatments is vital for optimizing patient care in managing venous diseases. As the field evolves, these findings could influence clinical decision-making, encouraging the adoption of techniques that promote better long-term outcomes for patients.
目的
在绵羊体内模型中描述空静脉消融（EVA）技术、腔内激光消融（EVLA）和泡沫硬化疗法（FS）后残留内膜及平均中膜厚度情况。
方法
对6条髂股静脉轴和2条颈静脉轴进行如下处理：4条采用EVA（使用0.5%或1%聚多卡醇[POL]，接触时间为1或3分钟），2条采用FS（FS-1以及在瓦尔萨尔瓦动作时进行FS[FS-Val]，1% POL持续10分钟），2条采用EVLA（1470 nm径向，80 J/cm）。
结果
EVA-POL0.5%-1分钟组残留内膜层平均百分比为2%（四分位间距[IQR]：1%-4%），EVA-POL0.5%-3分钟组为1%（IQR：0%-3.5%），EVA-POL1%-1分钟组为2%（IQR：0%-4%），EVA-POL1%-3分钟组为0，FS组为13%（IQR：13%-15.7%），FS-Val组为1%（IQR：0%-3%），EVLA组为1%（IQR：0%-6%）。EVA-POL0.5%-1分钟组残留中膜厚度平均百分比为13%（IQR：8%-15%），EVA-POL0.5%-3分钟组为6%（IQR：4%-9%），EVA-POL1%-1分钟组为13%（IQR：10%-27%），EVA-POL1%-3分钟组为6%（IQR：5%-12%），FS组为51%（IQR：40%-62%），FS-Val组为29%（IQR：23%-35%），EVLA组为62%（IQR：41%-75%）。
结论
在静脉壁损伤方面，EVA在内膜和中膜层均显示出比EVLA和FS更好的效果。
临床意义
本研究为不同静脉治疗技术，尤其是空静脉消融方法在最小化残留内膜和中膜厚度方面的有效性提供了关键见解。通过在绵羊模型中评估这些结果，突出了与腔内激光消融和泡沫硬化疗法相比，空静脉消融可能导致更多的静脉壁损伤。对于临床医生而言，了解这些治疗方法的比较疗效对于优化静脉疾病患者的护理至关重要。随着该领域的发展，这些发现可能会影响临床决策，促使采用能为患者带来更好长期效果的技术。
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