1
|
Duarte F, de Souza DM, Regueira Filho A, Bazzanella LJ, Del Castanhel F, de Oliveira Filho GR. Treatment of varicose great saphenous vein with endovenous laser alone or combined with eco-guided foam sclerotherapy: A randomized controlled trial. Phlebology 2024:2683555241263224. [PMID: 38889758 DOI: 10.1177/02683555241263224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Objectives: This study compares Endovenous Laser Ablation (EVLA) alone versus combined with ultrasound-guided foam sclerotherapy (UGFS) for Great Saphenous Vein (GSV) insufficiency. Methods: Sixty patients were randomly allocated to EVLA or EVLA-UGFS groups which focused on GSV occlusion rates, complications, additional treatments, and quality of life (QoL) changes. Results: Among 55 participants, the EVLA group had higher 12-month occlusion rates (92.3% vs. 75.8%, p = 0.11). Nervous injury (NI) was rarer in EVLA-UGFS (3.4% vs. 23.1%, p = 0.04). No significant difference in other complication rates (p > 0.05). QoL improved in both groups (p < 0.001). EVLA-UGFS required more subsequent procedures (24.1% vs. 7.7%, p = 0.03). Conclusions: EVLA and EVLA-UGFS effectively treat GSV insufficiency, enhancing QoL. The combined method reduces NI risk but may require more follow-up procedures.
Collapse
Affiliation(s)
- Fabricio Duarte
- Health Polyclinic of Joinville, Joinville, Brazil
- Municipal Hospital São José - HMSJ, Joinville, Brazil
| | | | | | | | - Flávia Del Castanhel
- Postgraduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | | |
Collapse
|
2
|
Yusupov V, Chudnovskii V. The origin of loud claps during endovenous laser treatments. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1525. [PMID: 37002106 DOI: 10.1121/10.0017436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/14/2023] [Indexed: 06/19/2023]
Abstract
Optoacoustic and ultrasound methods have shown that the loud "claps" perceived by patients and medical staff during endovenous laser ablation (EVLA) are caused by volumetric blood boiling when large vapor-gas bubbles appear and collapse under the action of laser radiation, which is well absorbed in water. Acoustic effects when using lasers in the near infrared range (1.94, 1.47, and 0.97 μm) were studied in an experiment with non-deaerated water, as well as in EVLA. The nature of these acoustic signals was investigated using high-speed video recording. It turned out that the amplitude of the emerging acoustic pulses in the case of surface boiling, which prevails when using lasers with a wavelength of 0.97 μm, is two orders of magnitude smaller than in the case of volumetric boiling (1.94 and 1.47 μm). The reasons for the decrease in sound effects in this case are associated with numerous microbubbles at the tip of the laser fiber. The results obtained may be useful for further understanding of the mechanisms of EVLA.
Collapse
Affiliation(s)
- Vladimir Yusupov
- Institute of Photon Technologies, FSRC "Crystallography and Photonics," Russian Academy of Sciences, Pionerskaya Street, 2, 108840 Moscow, Troitsk, Russia
| | - Vladimir Chudnovskii
- V.I. Il'ichev Pacific Oceanological Institute Far Eastern Branch Russian Academy of Sciences (POI FEB RAS), 43 Baltiyskaya Street, Vladivostok 690041, Russia
| |
Collapse
|
3
|
Park I, Kim JY, Lee H, Park G, Park J, Hwang H, Yun S, Ohe H, Hong KP, Park JK, Jang JH, Yun SS. Draft Revision of Clinical Practice Guidelines for Varicose Veins -Treatment-. Phlebology 2020. [DOI: 10.37923/phle.2020.18.2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Jang Yong Kim
- Division of Vascular and Transplant Surgery, Department of Surgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Hogyun Lee
- Division of Vascular and Transplant Surgery, Department of Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Geunmyeong Park
- Division of Vascular and Transplant Surgery, Department of Surgery, Inha University Hospital, Inchon, Korea
| | - Junho Park
- Happy Varicose Vein Clinic, Seoul, Korea
| | - Hongpil Hwang
- Division of Vascular and Transplant Surgery, Department of Surgery, Jeonbuk National University Hospital, Jeonju, Korea
| | - Sangchul Yun
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Haengjin Ohe
- Division of Vascular and Transplant, Department of Surgery, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Ki-Pyo Hong
- Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jong Kwon Park
- Division of Vascular and Transplant, Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | | | - Sang Seob Yun
- Division of Vascular and Transplant Surgery, Department of Surgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
| |
Collapse
|
4
|
Srivatsa SS, Chung S, Sidhu V. The relative roles of power, linear endovenous energy density, and pullback velocity in determining short-term success after endovenous laser ablation of the truncal saphenous veins. J Vasc Surg Venous Lymphat Disord 2019; 7:90-97. [DOI: 10.1016/j.jvsv.2018.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 07/26/2018] [Indexed: 11/27/2022]
|
5
|
Montminy ML, Jayaraj A, Raju S. A systematic review of the efficacy and limitations of venous intervention in stasis ulceration. J Vasc Surg Venous Lymphat Disord 2018; 6:376-398.e1. [DOI: 10.1016/j.jvsv.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/20/2017] [Indexed: 11/27/2022]
|
6
|
Bellam KPP, Joy B, Sandhyala A, Naiknaware K, Ray B, Vijayakumar. Technique, Efficiency and Safety of Different Nerve Blocks for Analgesia in Laser Ablation and Sclerotherapy for Lower Limb Superficial Venous Insufficiency - A Multicentre Experience. J Clin Diagn Res 2017; 10:TC13-TC17. [PMID: 28050474 DOI: 10.7860/jcdr/2016/22897.8874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 09/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Laser ablation and sclerotherapy, as minimally invasive alternatives to surgery for varicose veins, have good efficacy, safety and cosmetic result. Some form of anaesthesia is generally used for pain control. AIM To describe the technique and evaluate the efficacy and safety of femoral, saphenous and sciatic nerve blocks in isolation or in combination for analgesia during laser ablation and sclerotherapy for lower limb varicose veins. MATERIALS AND METHODS In this prospective observational study, over a period of 33 months, in 856 limbs of 681 patients with varicose veins, ultrasound guided femoral, saphenous and sciatic nerve blocks for analgesia were performed in 769, 808 and 52 instances respectively; following which, endovenous laser ablation, sclerotherapy or combination of both were carried out using standard practice. After completion of the procedure, Visual Analogue Pain Scale (VAS) was used for pain assessment, and muscle weakness was assessed clinically. RESULTS Nerve blocks could be successfully performed in all patients. Observed pain scores were 0 or 1 in 591 (69%), 2 or 3 in 214 (25%) and 4 in 51 (9%) legs with no score more than 4. Higher grades of pain were noted in femoral blocks during early stages of our learning curve. Mild to moderate muscle weakness was observed in 163 (2%) and 7 (13%) patients who underwent femoral and sciatic block respectively, which persisted for an average of two and a half hours and none beyond four and a half hours; saphenous nerve being a pure sensory nerve, did not cause motor weakness. CONCLUSION For analgesia during laser ablation and/or sclerotherapy of varicose veins, ultrasound guided nerve blocks can be easily and quickly performed. They provide excellent pain relief and comfort to the patient and to the operator; and they do not cause any additional complication.
Collapse
Affiliation(s)
| | - Binu Joy
- Head of Radiology Services, Department of Radiology, Rajagiri Hospital , Kochi, Kerala, India
| | - Abhilash Sandhyala
- Consultant Interventional Radiologist, Department of Radiology, Maxcure Hospitals , Hyderabad, Telangana, India
| | - Kiran Naiknaware
- Consultant Interventional Radiologist, Department of Radiology, Dr. D. Y. Patil Medical College Hospital and Research Center , Pune, Maharashtra, India
| | - Brijesh Ray
- Senior Specialist, Department of Imaging and Interventional Radiology, Aster Medcity Hospital , Kochi, Kerala, India
| | - Vijayakumar
- Consultant Interventional and Cardiac Radiologist, Radiology, Ramesh Hospitals , Guntur, Andhra Pradesh, India
| |
Collapse
|
7
|
Endovenous Laser Ablation for Incompetent Saphenous Vein Combined With Fluoroscopy-Guided Endovenous Foam Sclerotherapy in Varicose Tributaries: Long-Term Follow-up Results. Int Surg 2016. [DOI: 10.9738/intsurg-d-15-00285.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this study is to describe the long-term results of 980-nm endovenous laser ablation (EVLA) combined with fluoroscopy-guided endovenous foam sclerotherapy using a microcatheter into varicose tributaries. This report reviewed experiences with fluoroscopy-guided endovenous foam sclerotherapy using a microcatheter followed by EVLA, from July 2005 to November 2007. The sclerosing foam was injected through the microcatheter using 1% polidocanol or sodium tetradecyl sulfate. Patients were evaluated clinically and with duplex ultrasound from 1 week to 3 years to assess treatment efficacy and adverse reactions. Technical success was seen in 460 of 461 limbs (99.8%). Continued closure of the saphenous veins and complete sclerosis of varicose tributaries were noted in 351 of 408 limbs (86%) at 1-month follow-up, all 328 limbs at 3-month follow-up, all 299 limbs at 6-month follow-up, all 146 limbs at 1-year follow-up, all 94 limbs at 2-year follow-up, and all 32 limbs at 3-year follow-up. No serious complications were noted. Bruising was noted in 79.0%, and pain or tightness was noted in 68.4%. Hyperpigmentation was noted in 54.2%. EVLA for incompetent saphenous vein combined with endovenous foam sclerotherapy appears to offer the obvious benefits of less additional percutaneous sclerotherapy. However, many problems, like long-lasting pain and hyperpigmentation, can lessen the value of this procedure.
Collapse
|
8
|
Cowpland CA, Cleese AL, Whiteley MS. Factors affecting optimal linear endovenous energy density for endovenous laser ablation in incompetent lower limb truncal veins – A review of the clinical evidence. Phlebology 2016; 32:299-306. [DOI: 10.1177/0268355516648067] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The objective is to identify the factors that affect the optimal linear endovenous energy density (LEED) to ablate incompetent truncal veins. Methods We performed a literature review of clinical studies, which reported truncal vein ablation rates and LEED. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram documents the search strategy. We analysed 13 clinical papers which fulfilled the criteria to be able to compare results of great saphenous vein occlusion as defined by venous duplex ultrasound, with the LEED used in the treatment. Results Evidence suggests that the optimal LEED for endovenous laser ablation of the great saphenous vein is >80 J/cm and <100 J/cm in terms of optimal closure rates with minimal side-effects and complications. Longer wavelengths targeting water might have a lower optimal LEED. A LEED <60 J/cm has reduced efficacy regardless of wavelength. The optimal LEED may vary with vein diameter and may be reduced by using specially shaped fibre tips. Laser delivery technique and type as well as the duration time of energy delivery appear to play a role in determining LEED. Conclusion The optimal LEED to ablate an incompetent great saphenous vein appears to be >80 J/cm and <95 J/cm based on current evidence for shorter wavelength lasers. There is evidence that longer wavelength lasers may be effective at LEEDs of <85 J/cm.
Collapse
Affiliation(s)
| | | | - Mark S Whiteley
- The Whiteley Clinic, Stirling House, UK
- Faculty of Health and Biomedical Sciences, University of Surrey, UK
| |
Collapse
|
9
|
Zhou YT, Zhao XD, Jiang JW, Li XS, Wu ZH. Ozone Gas Bath Combined with Endovenous Laser Therapy for Lower Limb Venous Ulcers: A Randomized Clinical Trial. J INVEST SURG 2016; 29:254-9. [PMID: 27010682 DOI: 10.3109/08941939.2016.1149637] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Endovenous laser therapy (EVLT) is safe and effective for lower limb venous ulcers. However, severe necrosis and infection in the ulcer area are contraindications of puncture and EVLT. Local bath with ozone gas has been shown to improve the condition of ulcer areas. The aim of this study was to evaluate the clinical efficacy of ozone gas bath combined with EVLT in comparison with EVLT alone for the treatment for lower limb venous ulcers. PATIENTS AND METHODS Ninety-two patients with venous ulcers were randomized to receive ozone gas bath combined with EVLT (OEVLT group) or EVLT alone (EVLT group). In the OEVLT group, the venous ulcers were preconditioned with ozone gas bath prior to EVLT. The minimum follow-up time was 12 months. The two groups were compared in terms of complete occlusion of the treated veins, ulcer healing ratio, ratio of ulcer recurrence, patient satisfaction, complications, and side effects. RESULTS There was no significant difference in venous occlusion between the two groups. The ratio of ulcer healing in the OEVLT group was significantly higher than the EVLT group at 12 months follow-up. Patients in the OEVLT group showed better satisfaction and a lower recurrence ratio than the OEVLT group. No severe complications or side effects occurred in either groups. CONCLUSIONS Ozone gas bath combined with EVLT showed improved efficacy for the treatment of lower limb venous ulcers and lower recurrence ratio comparison with EVLT alone. This procedure is a safe and technically feasible.
Collapse
Affiliation(s)
- Yi-Ting Zhou
- a Department of Radiology , Wuxi Integrated Traditional Chinese and Western Medicine Hospital , Wuxi , China
| | - Xu-Dong Zhao
- b Department of Neurosurgery , Nanjing Medical University Wuxi Second Hospital , Wuxi , China
| | - Jian-Wei Jiang
- a Department of Radiology , Wuxi Integrated Traditional Chinese and Western Medicine Hospital , Wuxi , China
| | - Xin-Sheng Li
- a Department of Radiology , Wuxi Integrated Traditional Chinese and Western Medicine Hospital , Wuxi , China
| | - Zhen-Hai Wu
- a Department of Radiology , Wuxi Integrated Traditional Chinese and Western Medicine Hospital , Wuxi , China
| |
Collapse
|
10
|
Park YS, Kim YW, Park YJ, Kim DI. Clinical results of endovenous LASER ablation (EVLA) using low linear endovenous energy density (LEED) combined with high ligation for great saphenous varicose veins. Surg Today 2015; 46:1019-23. [PMID: 26689210 DOI: 10.1007/s00595-015-1289-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 10/13/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was designed to analyze the efficacy and complications in endovenous LASER ablation (EVLA) with 1470 nm diode lasers using low linear endovenous energy density (LEED) combined with high ligation for varicose veins of the great saphenous vein (GSV). METHODS One hundred and sixteen limbs of 102 patients were analyzed using 6 W with 2 mm/s constant pullback speed delivered by 30 J/cm LEED. The SFJ was ligated with a small inguinal incision. The complications and status of the GSV were checked at 1 and 6 months postoperatively. RESULTS The occlusion rates for the GSV were 98 (84.5 %) at 1 month and 116 (100 %) at 6 months, postoperatively. The rate of partial occlusion was higher in males than in females (p = 0.004). There were 2 DVT, 27 feelings of the cord (23.3 %), and 36 numbness at the knee area (31.0 %) at 1 month, and 3 feelings of the cord (3.4 %) and 6 numbness of the knee (8.6 %) at 6 months postoperatively. The diameter and depth of the GSV did not affect the rates of feeling of the cord or numbness (p = 0.728, 0.208, 0.247, 0.884, respectively). CONCLUSION EVLA with a 1470-nm diode laser using low LEED combined with high ligation for the GSV has lower complication rates and higher occlusion rates of GSV.
Collapse
Affiliation(s)
- Yoong-Seok Park
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Young-Wook Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Yang-Jin Park
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Dong-Ik Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
| |
Collapse
|
11
|
Sarma N. Guidelines and recommendation on surgery for venous incompetence and leg ulcer. Indian Dermatol Online J 2014; 5:390-5. [PMID: 25165682 PMCID: PMC4144250 DOI: 10.4103/2229-5178.137825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Nilendu Sarma
- Department of Dermatology, NRS Medical College, Kolkata, West Bengal, India
| |
Collapse
|
12
|
Park JA, Park SW, Chang IS, Hwang JJ, Lee SA, Kim JS, Chee HK, Yun IJ. The 1,470-nm bare-fiber diode laser ablation of the great saphenous vein and small saphenous vein at 1-year follow-up using 8-12 W and a mean linear endovenous energy density of 72 J/cm. J Vasc Interv Radiol 2014; 25:1795-800. [PMID: 25156646 DOI: 10.1016/j.jvir.2014.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/08/2014] [Accepted: 07/08/2014] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To demonstrate 1-year outcomes after low-energy endovenous laser ablation (EVLA) of incompetent saphenous veins with linear endovenous energy density (LEED) of 80 J/cm or lower with the use of a 1,470-nm diode laser. MATERIALS AND METHODS Incompetent saphenous veins in 236 patients (355 limbs; Clinical/Etiology/Anatomy/Pathophysiology classifications of C2-C4) were treated by EVLA with a bare-tipped 1,470-nm laser with LEED no greater than 80 J/cm (mean, 72.4 J/cm) and laser power of 8-12 W. Patients were evaluated clinically and with duplex ultrasonography at 1 week and 1, 3, 6, and 12 months after EVLA to assess the technical and clinical success and complication rates. RESULTS In the 355 limbs, the technical success rate was 100%. The great saphenous vein (GSV) remained occluded in all 229 limbs (100%) after 1 week, 202 of 203 limbs (99.5%) after 1 month, 157 of 158 limbs after 3 months (99.3%), all 99 limbs after 6 months (100%), and all 41 limbs after 1 year (100%). The small saphenous vein (SSV) remained occluded in all 103 limbs (100%) after 1 week, all 94 limbs (100%) after 1 month, 68 of 69 limbs (98.5%) after 3 months, 40 of 41 limbs (97.5%) after 6 months, and all 14 limbs after 1 year (100%). Two GSVs and two SSVs were recanalized and underwent repeated EVLA. No major complications occurred, although bruising (21% of cases), pain (15%), and paresthesia (4%) were observed. CONCLUSIONS Low-energy EVLA with the use of a 1,470-nm laser with LEED of 80 J/cm or lower is an effective, safe, and technically successful option for the treatment of incompetent saphenous veins.
Collapse
Affiliation(s)
- Jung Ah Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Sang Woo Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea.
| | - Il Soo Chang
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Jae Joon Hwang
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Song Am Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| |
Collapse
|
13
|
van Eekeren RR, Boersma D, de Vries JPP, Zeebregts CJ, Reijnen MM. Update of endovenous treatment modalities for insufficient saphenous veins—A review of literature. Semin Vasc Surg 2014; 27:118-36. [DOI: 10.1053/j.semvascsurg.2015.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|