An Italian experience with mechanochemical ablation of the saphenous vein since 2012
An Italian experience with mechanochemical ablation of the saphenous vein since 2012
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DOI：
10.1016/j.jvsv.2020.01.006
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发表时间：
2020-11-01
影响因子：
3.2
通讯作者：
Lino, Marcello
中科院分区：
文献类型：
--
作者：
Mirandola, Mattia;Griso, Andrea;Lino, Marcello
目的：机械化学静脉腔内消融是一种非热消融浅静脉功能不全的方法。本文的目的是评估短期并发症和5年随访outcome.Methods：这是一项前瞻性收集数据的回顾性单中心研究。我们在门诊治疗了395例原发性、症状性、单侧、功能不全的大隐静脉曲张。没有患者在同一次治疗中接受双边治疗。大隐静脉占92.3%，小隐静脉占1.3%。使用机械化学静脉内闭塞导管（ClariVein静脉内闭塞导管; Merit Medical，South Jordan，犹他州）和液体形式的2%聚多卡醇进行手术。结果：2012年9月至2017年9月期间治疗的329例患者可进行随访，平均随访时间为20 +/- 18个月（范围，6-60个月）。技术成功率为99.5%; 2例患者因静脉痉挛导致导管损坏和无法输注硬化剂而无法完成手术。术后1周、1个月、6个月、1年随访，每年随访1次。无再通的总生存率为92.4%。1年时解剖成功率为94%，2年时为91%，3年时为88%，4年时为88%，5年时为84%。在5年的随访包括23例患者，其中5人提出再通;此外，在这个系列中，在36%的情况下，静脉完全消失的双功超声scannes.Conclusions：的ClariVein导管是一个良好的闭塞率，与其他技术，包括热技术，没有重大并发症。
Objective: Mechanochemical endovenous ablation is a nonthermal method to ablate superficial incompetent veins. The aim of this paper was to assess short-term complications and 5-year follow-up outcomes.Methods: This is a retrospective single-center study of data collected prospectively. We treated, in an outpatient setting, 395 primary, symptomatic, unilateral, incompetent varicose saphenous veins. No patients were treated bilaterally in the same session. The majority were great saphenous veins (92.3%), and the others were small saphenous veins. Procedures were performed with a mechanochemical endovenous occlusion catheter (ClariVein endovenous occlusion catheter; Merit Medical, South Jordan, Utah) and polidocanol 2% in liquid form.Results: Follow-up was available for 329 patients treated between September 2012 and September 2017 with a mean follow-up time of 20 +/- 18 months (range, 6-60 months). Technical success was achieved in 99.5%; in two patients, we were unable to complete the procedures because of vein spasm leading to catheter damage and inability to infuse the sclerosant. Follow-up was performed with clinical evaluation and duplex ultrasound scan at 1 week, 1 month, 6 months, and 1 year and then once every year. The overall survival rate free from recanalization was 92.4%. Anatomic success is 94% at 1 year, 91% at 2 years, 88% at 3 years, 88% at 4 years, and 84% at 5 years. The follow-up at 5 years includes 23 patients, 5 of whom presented with recanalization; moreover, in this series, in 36% of cases, the veins completely disappeared on duplex ultrasound scan.Conclusions: The ClariVein catheter is associated with a good occlusion rate, comparable with other techniques including thermal techniques, without major complications.