Alt ekstremite variköz venlerinin endovenöz lazer ablasyonu: proksimal ve distal yollardaki sonuçların raporlanması
Öz
Amaç:Bu çalışmanın amacı izole variköz küçük safen ven tanısı alan ve endovenöz lazer ablasyon uygulanan hastalarda vasküler giriş yolunun (proksimal veya distal) postoperatif ağrı üzerine olan etkilerini değerlendirmektir.
Hastalar ve Yöntem:Çalışma varisli safen ven tanış alan 49 hastanın (35 kadın, 14 erkek) tıbbi dosyaları kullanılarak yapıldı. Endovenöz lazer ablasyonu 1470 nm emisyon dalga boyunda lazer enerjisi kullanılarak gerçekleştirildi. Ağrının değerlendirilmesi görsel analog skala kullanılarak 7., 1., 3. ve 6. aylarda yapıldı.
Bulgular:Kırk dokuz hastadan 30\'unda küçük safen veninin dizaltı distal kesiminden ve 19\'unda da küçük safen venin proksimalinden giriş yapıldı. Bu iki grubun sonuçları variköz venin proksimal geniş olan kısmından erişilebilmesinin, variköz venlerin endovenöz lazer ablasyon tedavisinde azalmış lokal ağrı skorları ile kolay bir yol sağladığını göstermiştir (p <0.001).
Sonuç:İzole variköz küçük safen ven tanısı alan ve endovenöz lazer ablasyon uygulanan hastalarda vasküler giriş yolunun (proksimal veya distal) postoperatif ağrı üzerine anlamlı bir etkisi olmasa da, proksimal giriş yolunun daha kolay erişildiği ve bu yolla işlemin daha kısa sürdüğü görülmüştür.
Anahtar Kelimeler
Kaynakça
- 1. Vemulapalli S, Parikh K, Coeytaux R, Hasselblad V, McBroom A, Johnston A, et al. Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veins. Am Heart J. 2018;196:131-143.
- 2. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl):2S-48S.
- 3. Mallick R, Raju A, Campbell C, Carlton R, Wright D, Boswell K, et al. Treatment Patterns and Outcomes in Patients with Varicose Veins. Am Health Drug Benefits. 2016;9(8):455-465.
- 4. Spiliopoulos S, Theodosiadou V, Sotiriadi A, Karnabatidis D. Endovenous ablation of incompetent truncal veins and their perforators with a new radiofrequency system. Mid-term outcomes. Vascular 2015;23(6):592-8.
- 5. Altin FH, Aydin S, Erkoc K, Gunes T, Eygi B, Kutas BH. Endovenous laser ablation for saphenous vein insufficiency: short- and mid-term results of 230 procedures. Vascular 2015;23(1):3-8.
- 6. Navarro L, Min RJ, Boné C. Endovenous laser: a new minimally invasive method of treatment for varicose veins—preliminary observations using an 810 nm diode laser. Dermatol Surg 2001;27:117-22.
- 7. van den Bos R, Arends L, Kockaert M, Neumann M, Nijsten T. Endovenous therapies of lower extremity varicosities: a meta-analysis. J Vasc Surg 2009;49:230-9.
- 8. Rustempasic N, Cvorak A, Agincic A. Outcome of endovenous laser ablation of varicose veins. Acta Inform Med 2014;22(5):329-32.
- 9. Tassie E, Scotland G, Brittenden J, Cotton SC, Elders A, Campbell MK, et al.; CLASS study team. Cost-effectiveness of ultrasound-guided foam sclerotherapy, endovenous laser ablation or surgery as treatment for primary varicose veins from the randomized CLASS trial. Br J Surg 2014;101(12):1532-40.
- 10. Proebstle TM, Moehler T, Herdemann S. Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent. J Vasc Surg 2006;44:834-9.
- 11. Chen JQ, Xie H, Deng HY, Yuan K, Zhang JW, Zhang H, et al. Endovenous laser ablation of great saphenous vein with ultrasound guided perivenous tumescence: early and midterm results. Chinese Med J 2013;126:421-5.
- 12. Pritchard M. Measuring anxiety in surgical patients using a visual analogue scale. Nurs Stand 2010;25(11):40-4.
- 13. Oguzkurt L. Ultrasonographic anatomy of the lower extremity superficial veins. Diagn Interv Radiol 2012;18:423-30.
- 14. Ozkan U, Sariturk C. Early clinical improvement in chronic venous insufficiency symptoms after laser ablation of saphenous veins. Diagn Interv Radiol 2012;18:594-8.
- 15. Sadek M, Kabnick LS, Berland T, Cayne NS, Mussa F, Maldonado T, et al. Update on Endovenous Laser Ablation: 2011. Perspect Vasc Surg Endovasc Ther 2011;23:233-7.
- 16. Schwarz T, von Hodenberg E, Furtwängler C, Rastan A, Zeller T, Neumann FJ. Endovenous laser ablation of varicose veins with the 1470-nm diode laser. J Vasc Surg 2010;51:1474-1478.
- 17. Proebstle TM, Moehler T, Herdemann S. Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent. J Vasc Surg 2006; 44: 83483-83489.
- 18. Lun Y, Shen S, Wu X, Jiang H, Xin S, Zhang J. Laser fiber migration into the pelvic cavity: A rare complication of endovenous laser ablation. Phlebology 2015 Oct;30(9):641-3.
- 19. Ostler AE, Holdstock JM, Harrison CC, Whiteley MS. Arterial false aneurysm in the groin following endovenous laser ablation. Phlebology 2015 Apr;30(3):220-2.
- 20. Can Caliskan K, Cakmakci E, Celebi I, Basak M. Endovenous 1470 nm laser treatment of the saphenous vein: early report of pain assessment. J Cardiovasc Surg (Torino) 2013;54(2):263-7.
- 21. Duman E, Yildirim E, Saba T, Ozulku M, Gunday M, Coban G. The effect of laser wavelength on postoperative pain score in the endovenous ablation of saphenous vein insufficiency. Diagn Interv Radiol 2013;19(4):326-9.
- 22. Dumantepe M, Uyar I. Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser. Phlebology 2015;30(1):45-51.
- 21. Puggioni A, Kalra M, Carmo M, Mozes G, Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg 2005;42:488-493.
Endovenous laser ablation of lower limb varicose veins: report of results in proximal and distal routes
Öz
Purpose:The aim of this study is to evaluate the effects of vascular access (proximal or distal) on postoperative pain in patients diagnosed with isolated varicose small saphenous vein who underwent endovenous laser ablation.
Patients and Methods:Medical records of 49 patients (35 female, 14 male) with isolated saphenous venous insufficiency were reviewed. Endovenous laser ablation was performed in all patients at an emission wavelength of 1470 nm, using 7 Watt laser energy at the proximal and distal ports. Pain was evaluated using visual analog scale at 7 days, 1, 3 and 6 months.
Results:In 30 of the 49 patients vascular access was performed from the distal to the below the knee section of the small saphenous vein and in 19 cases from proximal to the small saphenous vein. The results of these two groups showed that access into the larger proximal part of the varicose vein provides an easy route with reduced local pain scores in endovenous laser ablation of varicose veins (p <0.001).
Conclusion:In patients diagnosed with isolated varicose small saphenous vein and undergoing endovenous laser ablation, the vascular access route (proximal or distal) did not have a significant effect on postoperative pain, but the proximal route was more easily accessed and the procedure lasted shorter.
Anahtar Kelimeler
Kaynakça
- 1. Vemulapalli S, Parikh K, Coeytaux R, Hasselblad V, McBroom A, Johnston A, et al. Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veins. Am Heart J. 2018;196:131-143.
- 2. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl):2S-48S.
- 3. Mallick R, Raju A, Campbell C, Carlton R, Wright D, Boswell K, et al. Treatment Patterns and Outcomes in Patients with Varicose Veins. Am Health Drug Benefits. 2016;9(8):455-465.
- 4. Spiliopoulos S, Theodosiadou V, Sotiriadi A, Karnabatidis D. Endovenous ablation of incompetent truncal veins and their perforators with a new radiofrequency system. Mid-term outcomes. Vascular 2015;23(6):592-8.
- 5. Altin FH, Aydin S, Erkoc K, Gunes T, Eygi B, Kutas BH. Endovenous laser ablation for saphenous vein insufficiency: short- and mid-term results of 230 procedures. Vascular 2015;23(1):3-8.
- 6. Navarro L, Min RJ, Boné C. Endovenous laser: a new minimally invasive method of treatment for varicose veins—preliminary observations using an 810 nm diode laser. Dermatol Surg 2001;27:117-22.
- 7. van den Bos R, Arends L, Kockaert M, Neumann M, Nijsten T. Endovenous therapies of lower extremity varicosities: a meta-analysis. J Vasc Surg 2009;49:230-9.
- 8. Rustempasic N, Cvorak A, Agincic A. Outcome of endovenous laser ablation of varicose veins. Acta Inform Med 2014;22(5):329-32.
- 9. Tassie E, Scotland G, Brittenden J, Cotton SC, Elders A, Campbell MK, et al.; CLASS study team. Cost-effectiveness of ultrasound-guided foam sclerotherapy, endovenous laser ablation or surgery as treatment for primary varicose veins from the randomized CLASS trial. Br J Surg 2014;101(12):1532-40.
- 10. Proebstle TM, Moehler T, Herdemann S. Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent. J Vasc Surg 2006;44:834-9.
- 11. Chen JQ, Xie H, Deng HY, Yuan K, Zhang JW, Zhang H, et al. Endovenous laser ablation of great saphenous vein with ultrasound guided perivenous tumescence: early and midterm results. Chinese Med J 2013;126:421-5.
- 12. Pritchard M. Measuring anxiety in surgical patients using a visual analogue scale. Nurs Stand 2010;25(11):40-4.
- 13. Oguzkurt L. Ultrasonographic anatomy of the lower extremity superficial veins. Diagn Interv Radiol 2012;18:423-30.
- 14. Ozkan U, Sariturk C. Early clinical improvement in chronic venous insufficiency symptoms after laser ablation of saphenous veins. Diagn Interv Radiol 2012;18:594-8.
- 15. Sadek M, Kabnick LS, Berland T, Cayne NS, Mussa F, Maldonado T, et al. Update on Endovenous Laser Ablation: 2011. Perspect Vasc Surg Endovasc Ther 2011;23:233-7.
- 16. Schwarz T, von Hodenberg E, Furtwängler C, Rastan A, Zeller T, Neumann FJ. Endovenous laser ablation of varicose veins with the 1470-nm diode laser. J Vasc Surg 2010;51:1474-1478.
- 17. Proebstle TM, Moehler T, Herdemann S. Reduced recanalization rates of the great saphenous vein after endovenous laser treatment with increased energy dosing: definition of a threshold for the endovenous fluence equivalent. J Vasc Surg 2006; 44: 83483-83489.
- 18. Lun Y, Shen S, Wu X, Jiang H, Xin S, Zhang J. Laser fiber migration into the pelvic cavity: A rare complication of endovenous laser ablation. Phlebology 2015 Oct;30(9):641-3.
- 19. Ostler AE, Holdstock JM, Harrison CC, Whiteley MS. Arterial false aneurysm in the groin following endovenous laser ablation. Phlebology 2015 Apr;30(3):220-2.
- 20. Can Caliskan K, Cakmakci E, Celebi I, Basak M. Endovenous 1470 nm laser treatment of the saphenous vein: early report of pain assessment. J Cardiovasc Surg (Torino) 2013;54(2):263-7.
- 21. Duman E, Yildirim E, Saba T, Ozulku M, Gunday M, Coban G. The effect of laser wavelength on postoperative pain score in the endovenous ablation of saphenous vein insufficiency. Diagn Interv Radiol 2013;19(4):326-9.
- 22. Dumantepe M, Uyar I. Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser. Phlebology 2015;30(1):45-51.
- 21. Puggioni A, Kalra M, Carmo M, Mozes G, Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg 2005;42:488-493.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Aralık 2020 |
| Gönderilme Tarihi | 3 Kasım 2019 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 12 Sayı: 1 |
