Deak ST
Journal of vascular surgery. Venous and lymphatic disorders. Date of publication 2022 Sep 1;volume 10(5):999-1006.e2.
1. J Vasc Surg Venous Lymphat Disord. 2022 Sep;10(5):999-1006.e2. doi:
10.1016/j.jvsv.2021.11.007. Epub 2021 Dec 24.
Treatment of superficial venous insufficiency in a large patient cohort with
retrograde administration of ultrasound-guided polidocanol endovenous microfoam
versus endovenous laser ablation.
Deak ST(1).
Author information:
(1)Deak Vein NJ Clinic, Somerset, NJ. Electronic address: stdeak@gmail.com.
OBJECTIVE: To evaluate outcomes among symptomatic patients with superficial
chronic venous insufficiency treated with retrograde ultrasound-guided
polidocanol endovenous microfoam 1% (PEM) or endovenous laser ablation (EVLA).
METHODS: This study is a retrospective chart review from a single vein center
between October 2013 and June 2019. Procedures were performed on 1070 patients
with Clinical, Etiologic, Anatomic, and Pathophysiologic class 2 to 6 disease
and symptomatic superficial venous reflux of the great saphenous vein or
anterior accessory saphenous vein.
RESULTS: PEM was used for 550 procedures and patients were followed for 43 ±
13 months; EVLA was used for 520 procedures and patients were followed for 57 ±
18 months. After complete treatment, the elimination of reflux was documented in
93.5% (514/550) and 92.8% (482/520) of the PEM and EVLA procedures,
respectively. During the follow-up period, 18% of patients treated with EVLA
returned for additional treatment to address residual symptoms in the affected
leg. In C6 patients treated with PEM, 69% of ulcers (11/16) healed in less than
1 month, compared with 5% of patients (1/21) treated with EVLA. In C4 patients
with lesions, resolution of spontaneous bleeding was 100% in both groups. There
were no neurological or cardiac adverse events in the PEM group. Minor
complications included asymptomatic deep vein thrombosis (0.5%), one common
femoral vein thrombus extension, and superficial venous thrombosis (4%) in the
PEM group and asymptomatic deep vein thrombosis (0.8%) and two endovenous
heat-induced thromboses in the EVLA group.
CONCLUSIONS: PEM is comparable in safety and efficacy with EVLA for the
treatment of saphenous reflux and associated symptoms. PEM was an effective
intervention for most patients with C6 disease. Closure rates in both groups
were maintained 36 months after treatment.
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
DOI: 10.1016/j.jvsv.2021.11.007
PMID: 34958977 [Indexed for MEDLINE]
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