Lower pain and faster treatment with mechanico-chemical endovenous ablation using ClariVein®
Lower pain and faster treatment with mechanico-chemical endovenous ablation using ClariVein®
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DOI：
10.1177/0268355514553693
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发表时间：
2015-12-01
期刊：
影响因子：
1.7
通讯作者：
Spark, J. I.
中科院分区：
文献类型：
--
作者：
Vun, S. V.;Rashid, S. T.;Spark, J. I.
目的评价ClariVein(R)系统治疗浅静脉功能不全的疗效。方法采用显微穿刺法，在距隐股交界处1.5 cm处置入导管。与激光(静脉腔内激光治疗(EVLT))或射频消融(RFA)不同，不需要肿胀。这项技术依赖于在注入液体硬化剂(1.5%十四烷基硫酸钠)时，以3500r/min的速度旋转的钢丝造成内皮损伤。钢丝被拉回，同时沿着目标血管的长度连续注入硬化剂。最初，使用了8毫升稀释硬化剂，但随后增加到12毫升。没有常规的术后止痛处方，特别是没有非类固醇抗炎药。记录手术次数和疼痛评分(视觉模拟评分)，并与EVLT和RFA进行比较。结果自2011年7月开始的10个月内，共治疗大隐静脉51例，短隐静脉6例，并进行了随访。无严重并发症或深静脉血栓形成的报道。Duplex显示有三条处理过的静脉通畅，另外两条静脉只有较短的闭塞长度，技术成功率为91%。与50例RFA和40例EVLT比较，ClariVenue(R)组手术时间(23.08.3分钟)明显少于RFA组(37.9±8.3分钟)或EVLT组(44.1±11.4分钟)。Clarivin(R)的平均疼痛评分显著低于RFA和EVLT(1比5比6，P90%)，这与有限发表的文献一致。手术时间和疼痛评分明显优于RFA和EVLT。我们等待长期的临床结果。
Objectives To assess the efficacy of the ClariVein (R) system of mechanico-chemical ablation of superficial vein incompetence.Method ClariVein (R) treatment uses a micropuncture technique and a 4-Fr sheath to allow a catheter to be placed 1.5cm from the saphenofemoral junction. Unlike laser (endovenous laser treatment (EVLT)) or radiofrequency ablation (RFA), no tumescence is required. The technique depends on a wire rotating at 3500r/min causing endothelial damage whilst liquid sclerosant (1.5% sodium tetradecyl sulphate) is infused. The wire is pulled back whilst continuously infusing sclerosant along the target vessel's length. Initially, 8mL of dilute sclerosant was used, but this was subsequently increased to 12 mL. No routine post-op analgesia was prescribed and specifically no non-steroidal anti-inflammatory drugs. Procedure times and pain scores (visual analogue scale) were recorded and compared to EVLT and RFA. All patients were invited for duplex post-procedure.Results Fifty-one great saphenous veins and six short saphenous veins were treated and followed up with duplex in the 10 months from July 2011. No major complications or deep vein thrombosis were reported. Duplex showed patency of three treated veins with two more veins having only a short length of occlusion, giving a technical success rate of 91%. Comparison with 50 RFA and 40 EVLT showed procedure times were significantly less for ClariVein (R) (23.08.3min) than for either RFA (37.9 +/- 8.3min) or EVLT (44.1 +/- 11.4min). Median pain scores were significantly lower for ClariVein (R) than RFA and EVLT (1 vs. 5 vs. 6, p90% which accords with the limited published literature. Procedure times and pain scores are significantly better than for RFA and EVLT. We await the long-term clinical outcomes.