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Chapagain D, Shrestha KP, Thapa Magar D, Shrestha KB, Yadav PK. Recurrence of Varicose Vein after Endovenous Laser Therapy in a Tertiary Care Center: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:267-270. [PMID: 34506441 PMCID: PMC8369548 DOI: 10.31729/jnma.6163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Varicosity is the common problem of various etiology having simple limb aching to worst complications like oedema, ulcer, and skin changes. Minimal invasive endovenous laser therapy is a noble procedure. The aim of the study is to find out the recurrence of the varicose vein after laser therapy in a tertiary care center. Methods: This descriptive cross-sectional study was done in 38 patients with varicosity of the lower limb in a tertiary care hospital, from January 2019 to June 2019 after taking ethical clearance from Institutional Review Committee. Convenience sampling was done. Data was collected and entry was done in Statistical Package for the Social Science software version 22, point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: We recorded 38 patients with ablated limb out of which none of the ablated veins showed recanalization in six months follow up. Twenty two (58%) patients were male and 16 (42%) patients were female with a mean age of 40.26 years. Major bulk, 23 (60.5%) resumed activity in second postoperative day and only 1 (2.6%) patient waited for 5 days for normal activity with mean of 2.58 days postoperatively. Sixteen (42.1%) patients developed erythema or ecchymosis, 12 (31.6%) patients had induration along the long saphenous vein course, 7 (18.4%) patients had paresthesia, 2 (5.3%) patients had limb swelling and 1 (2.6%) patient had skin burn. Conclusions: Endovenous laser ablation has very low rate of recurrence of varicosity and has minor complications.
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Affiliation(s)
- Dinesh Chapagain
- Department of Cardiothoracic and Vascular Surgery (CTVS), National Academy of Medical Sciences, Bir Hospital, Mahabauddha, Kathmandu, Nepal
| | - Kiran Prasad Shrestha
- Department of Cardiothoracic and Vascular Surgery (CTVS), National Academy of Medical Sciences, Bir Hospital, Mahabauddha, Kathmandu, Nepal
| | - Deepak Thapa Magar
- Department of Cardiothoracic and Vascular Surgery (CTVS), National Academy of Medical Sciences, Bir Hospital, Mahabauddha, Kathmandu, Nepal
| | - Kumar Bahadur Shrestha
- Department of Cardiothoracic and Vascular Surgery (CTVS), National Academy of Medical Sciences, Bir Hospital, Mahabauddha, Kathmandu, Nepal
| | - Pramod Kumar Yadav
- Department of Cardiothoracic and Vascular Surgery (CTVS), National Academy of Medical Sciences, Bir Hospital, Mahabauddha, Kathmandu, Nepal
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Ucaroglu ER, Korkmaz UTK, Yuksel A, Velioglu Y, Unal O, Erdem K. A Novel Modified Technique with a Combination of Percutaneous Embolization with N-Butyl Cyanoacrylate and High Ligation of Saphenous Vein: a Preliminary Report. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Sevil F, Colak A, Ceviz M, Kaya U, Becit N. The Effectiveness of Endovenous Radiofrequency Ablation Application in Varicose Vein Diseases of the Lower Extremity. Cureus 2020; 12:e7640. [PMID: 32399372 PMCID: PMC7216314 DOI: 10.7759/cureus.7640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We aimed to determine the outcome, complications, and quality of life effects of radiofrequency ablation (RFA) in the treatment of superficial venous insufficiency. A total of 134 extremities from 100 patients were evaluated in this retrospective study performed at the Cardiovascular Surgery Department of Atatürk University Faculty of Medicine. Treatment success was determined by occlusion. The clinical, etiologic, anatomic, and pathophysiologic (CEAP) and venous clinical severity score (VCSS) scores of patients were assessed pre- and postoperatively to evaluate clinical outcome and quality of life. The pain was assessed with the Wong-Baker score. Complications and their frequency were assessed and recorded. Treatment success, as measured by occlusion rate, was 99% percent. Prior to treatment, the CEAP clinical score was C2 (81.0%), while after treatment, it was C0 (54.0%) (p<0.001). The pretreatment median VCSS score was 5 (min-max: 1-9) while the post-treatment median was 1 (min-max: 1-3) (p<0.001). The mean pain score was 1.34; only one patient reported a score of 6 while the minimum score was 1. A total of 15 complications occurred; only one was a major complication (deep vein thrombosis or DVT) while the remaining 14 were minor complications. While longstanding surgical treatments still provide significant success, the RFA technique not only surpasses them in success rate but also in terms of pain, complications, and better patient satisfaction. The results of our study indicate that RFA is an effective and safe option for the treatment of superficial venous insufficiency.
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Affiliation(s)
- Fehimcan Sevil
- Cardiovascular Surgery, Afyon Health Sciences University, Afyon, TUR
| | - Abdurrahim Colak
- Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR
| | - Münacettin Ceviz
- Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR
| | - Uğur Kaya
- Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR
| | - Necip Becit
- Cardiovascular Surgery, Afyon Medical Sciences University, Afyon, TUR
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Oliveira RDÁ, Mazzucca ACP, Pachito DV, Riera R, Baptista-Silva JCDC. Evidence for varicose vein treatment: an overview of systematic reviews. SAO PAULO MED J 2018; 136:324-332. [PMID: 30020324 PMCID: PMC9881696 DOI: 10.1590/1516-3180.2018.0003240418] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 04/24/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Varicose veins affect nearly 30% of the world's population. This condition is a social problem and needs interventions to improve quality of life and reduce risks. Recently, new and less invasive methods for varicose vein treatment have emerged. There is a need to define the best treatment options and to reduce the risks and costs. Since there are cosmetic implications, treatments for which effectiveness remains unproven present risks to consumers and higher costs for stakeholders. These risks and costs justify conducting an overview of systematic reviews to summarize the evidence. DESIGN AND SETTING Overview of systematic reviews within the Discipline of Evidence-Based Health, at Universidade Federal de São Paulo (UNIFESP). METHODS Systematic reviews on clinical or surgical treatments for varicose veins were included, with no restrictions on language or publication date. RESULTS 51 reviews fulfilled the inclusion criteria. Outcomes and comparators were described, and a narrative review was conducted. Overall, there was no evidence that compression stockings should be recommended for patients as the initial treatment or after surgical interventions. There was low to moderate evidence that minimally invasive therapies (endovenous laser therapy, radiofrequency ablation or foam sclerotherapy) are as safe and effective as conventional surgery (ligation and stripping). Among these systematic reviews, only 18 were judged to present high quality. CONCLUSIONS There was evidence of low to moderate quality that minimally invasive treatments, including foam sclerotherapy, laser and radiofrequency therapy are comparable to conventional surgery, regarding effectiveness and safety for treatment of varicose veins.
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Affiliation(s)
- Ricardo de Ávila Oliveira
- MD, MSc. Vascular Surgeon, Adjunct Professor, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), and Postgraduate Student in the Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Andréa Castro Porto Mazzucca
- BSc. Pharmacist and Postgraduate Student in the Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Daniela Vianna Pachito
- MD, MSc. Neurologist and Postgraduate Student in the Evidence-Based Health Program, Universidade Federal de São Paulo, (UNIFESP), São Paulo (SP), Brazil.
| | - Rachel Riera
- MD, PhD. Rheumatologist, Assistant Professor of the Discipline of Evidence-based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), and Assistant Coordinator at Cochrane Brazil, São Paulo (SP), Brazil.
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5
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Poder TG, Fisette JF, Bédard SK, Despatis MA. Is radiofrequency ablation of varicose veins a valuable option? A systematic review of the literature with a cost analysis. Can J Surg 2018; 61:128-138. [PMID: 29582749 PMCID: PMC5866149 DOI: 10.1503/cjs.010114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Since the 1990s, new techniques for the treatment of varicose veins have emerged, including radiofrequency ablation (RFA) and laser treatment. We performed a study to compare the safety, efficacy and outcomes of RFA compared to those of open surgery and laser ablation for the treatment of varicose veins. We also carried out a cost analysis of RFA compared to open surgery to assess whether RFA could help free up operating room time by being performed in an outpatient context. METHODS We conducted a systematic literature review (publication date May 2010-September 2013 for articles in English, January 1991-September 2013 for those in French). We used several checklists to measure the quality of the studies. We also collected data on costing. RESULTS The literature search identified 924 publications, of which 38 were retained for analysis: 15 literature reviews, 1 good-practice guideline and 22 new primary studies. The overall level of evidence was low to moderate owing to the limited sample sizes, lack of information on patient characteristics and lack of standardization of the outcome measures. However, the results obtained are consistent from study to study. In the short and medium term, RFA is considered as effective as open surgery or laser treatment (moderate level of evidence) and presents fewer major and minor complications than open surgery (low level of evidence). Radiofrequency ablation can be performed on an outpatient basis. We calculated that RFA would be about $110-$220 more expensive per patient than open surgery. CONCLUSION Radiofrequency ablation is a valuable alternative to open surgery and would free up operating room time in a context of low accessibility.
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Affiliation(s)
- Thomas G Poder
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
| | - Jean-François Fisette
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
| | - Suzanne K Bédard
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
| | - Marc-Antoine Despatis
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
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Vos CG, Ünlü Ç, Bosma J, van Vlijmen CJ, de Nie AJ, Schreve MA. A systematic review and meta-analysis of two novel techniques of nonthermal endovenous ablation of the great saphenous vein. J Vasc Surg Venous Lymphat Disord 2017; 5:880-896. [PMID: 29037363 DOI: 10.1016/j.jvsv.2017.05.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 05/28/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Endothermal treatment of the great saphenous vein (GSV) has become the first-line treatment for superficial venous reflux. Nonthermal ablation has potential benefits for acceptability by patients and decreased risk of nerve injury. We performed a systematic review and meta-analysis to evaluate the efficacy of mechanochemical endovenous ablation (MOCA) and cyanoacrylate vein ablation (CAVA) for GSV incompetence. METHODS MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases were searched for papers published between January 1966 and December 2016. Eligible articles were prospective studies that included patients treated for GSV incompetence and described the primary outcome. Exclusion criteria were full text not available, case reports, retrospective studies, small series (n < 10), reviews, abstracts, animal studies, studies of small saphenous vein incompetence, and recurrent GSV incompetence. Primary outcome was anatomic success. Secondary outcomes were initial technical success, Venous Clinical Severity Score, Aberdeen Varicose Vein Questionnaire score, and complications. RESULTS Fifteen articles met the inclusion criteria. Pooled anatomic success for MOCA and CAVA was 94.7% and 94.8% at 6 months and 94.1% and 89.0% at 1 year, respectively. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire score significantly improved after treatment with MOCA and CAVA. CONCLUSIONS These results are promising for these novel techniques that could serve as alternatives for thermal ablation techniques. However, to determine their exact role in clinical practice, high-quality randomized controlled trials comparing these novel modalities with well-established techniques are required.
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Affiliation(s)
- Cornelis G Vos
- Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands.
| | - Çağdaş Ünlü
- Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands
| | - Jan Bosma
- Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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Fernández-Samos Gutiérrez R. La vena lo soporta todo. ANGIOLOGIA 2016. [DOI: 10.1016/j.angio.2015.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bunnell AP, Zaidi S, Eidson JL, Bohannon WT, Atkins MD, Bush RL. Factors Associated with Saphenous Vein Recanalization after Endothermal Ablation. Ann Vasc Surg 2015; 29:322-7. [DOI: 10.1016/j.avsg.2014.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/23/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022]
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Rustempasic N, Cvorak A, Agincic A. Outcome of endovenous laser ablation of varicose veins. Acta Inform Med 2014; 22:329-32. [PMID: 25568583 PMCID: PMC4272832 DOI: 10.5455/aim.2014.22.329-332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 10/25/2014] [Indexed: 11/25/2022] Open
Abstract
Introduction: In Bosnia and Herzegovina according to available data, treatment of incompetent superficial lower extremity varicose veins by endovenous laser ablation (EVLA) has been introduced two years ago and so far no paper has been published regarding results of EVLA treatment of patients from our country. We wanted to present our results with EVLA treatment. Aim of study: to evaluate and compare primary posttreatment outcomes of endovenous laser ablation (EVLA) with classical surgical method of varicose vein treatment. Patients and methods: The study was clinical and prospective. It was carried out at Clinic for vascular surgery in Sarajevo where fifty-eight (58) patients received surgical treatment for varicose veins and in Aesthetic Surgery Center “Nasa mala klinika” in Sarajevo were sixty-one (61) patients with varicose veins were treated by endovenous laser ablation. Total 119 patients (limbs) with pathologic reflux only in great saphenous vein were evaluated between 1st of January 2013 and 31st of April 2014. Following primary outcome endpoints were evaluated smean day of return to normal everyday activities, patient subjective quantification of pain during first seven days after intervention, incidence of deep venous thrombosis (DVT), incidence of wound bleeding requiring surgical intervention, incidence of peri-saphenous vein hematoma and infection rate. Results: Mean of return to normal activities (expressed in days after intervention); EVLA vs. stripping (surgery) =1.21vs12.24, T test 13,619; p=0, 000, p<0,05. T test was used for comparing Mean value of visual pain analog scale for the first 7 days between groups, for all seven days pain was significantly higher in surgical group of patients as compared to EVLA group; p<0,05. Incidence of hematoma greater than 1% of total body surface area was significantly higher in patients receiving surgical treatment; Pearson Chi Square=23,830, p<0,05; odds ratio:10,453. Incidences of infection, deep venous thrombosis and posttreatment bleeding were not statistically different between analyzed groups; EVLA vs Surgery (Pearson Chi Square =3,237; p>0,05; Pearson Chi Square=2,139, p>0,05, Pearson Chi Square=2,139, p>0,05, respectively.) Conclusion: EVLA offers better patient recovery in terms of significantly lower post treatment pain, faster return to everyday activities and lower incidence of bruising (hematomas).
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Affiliation(s)
- Nedzad Rustempasic
- Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Alemko Cvorak
- Clinic for Plastic and Reconstructive Surgery, Clinical Center of University of Sarajevo, Sarajevo, Bosnia and Herzegovna
| | - Alija Agincic
- Clinic for Plastic and Reconstructive Surgery, Clinical Center of University of Sarajevo, Sarajevo, Bosnia and Herzegovna
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Elderman JH, Krasznai AG, Voogd AC, Hulsewé KW, Sikkink CJ. Role of compression stockings after endovenous laser therapy for primary varicosis. J Vasc Surg Venous Lymphat Disord 2014; 2:289-96. [DOI: 10.1016/j.jvsv.2014.01.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/18/2013] [Accepted: 01/20/2014] [Indexed: 11/25/2022]
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Pavlović MD, Schuller-Petrović S, Pichot O, Rabe E, Maurins U, Morrison N, Pannier F. Guidelines of the First International Consensus Conference on Endovenous Thermal Ablation for Varicose Vein Disease--ETAV Consensus Meeting 2012. Phlebology 2014; 30:257-73. [PMID: 24534341 DOI: 10.1177/0268355514524568] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM Endovenous thermal ablation (ETA) procedures are catheter-directed, ultrasound (US)-guided thermal methods for treatment in varicose veins disease. Radiofrequency, laser or steam energy thermally denatures vein wall collagen, leading first to vein wall inflammation, then fibrosis and finally to occlusion. The aim of this guideline is to give evidence-based recommendations for ETA procedures. METHODS These guidelines were drafted during a consensus meeting of a group of experts in the field of ETA in June 2012 (Hvar, Croatia) under the auspices of the International Union of Phlebology (IUP). These guidelines review the present state of knowledge as reflected in peer-reviewed published medical literature. The recommendations of these guidelines are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. RESULTS Recommendations on the use of ETA procedures were made based on the quality of evidence for efficacy, safety, tolerability, cosmetic outcome, patient satisfaction/preference and, where appropriate, on the experts' opinion. Health economics were not considered, since differences in national health systems and pricing make it difficult to form general conclusions that are relevant at an international level.
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Affiliation(s)
- Miloš D Pavlović
- Dermatology Centre Parmova & DCP-Venex Centre, Ljubljana, Slovenia
| | | | | | - Eberhard Rabe
- Department of Dermatology, University of Bonn, Bonn, Germany
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Griffin KJ, Cousins S, Bailey MA, Berridge D, Scott DJA. Primary care trust commissioning of varicose vein intervention--new guidance needed? Phlebology 2013; 29:505-10. [PMID: 23761877 DOI: 10.1177/0268355513492314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES In light of evidence of national variability in service commissioning of varicose vein intervention, our aim was to evaluate the current state of primary care trust commissioning for all forms of varicose vein intervention in England. We also sought to clarify the extent to which access to endovenous and surgical varicose vein services is being restricted. METHODS Under the Freedom of Information Act (2001), a structured email survey was sent to 108 primary care trusts in England. Trusts were asked how many elective endovenous laser therapy and open procedures were commissioned from 2008 to 2011 and they were asked to submit their commissioning policy for analysis. The 'qualifying criteria' expressed in each policy were analysed by theme and geographical region. RESULTS Of 108 surveys, 95 (88%) were completed and returned. Of these, 91 (96%) stated that varicose vein interventions were actively commissioned. Eighty-eight (97%) of primary care trusts that commissioned varicose vein interventions stated that access was restricted. Qualifying criteria varied considerably between regions. CONCLUSIONS Access to varicose vein intervention appears to be restricted, with national variation in commissioning across England. This might have an impact on patient care and surgical training. We propose that a national decision be made about which varicose vein patients should be offered funding for treatment on the National Health Service.
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Affiliation(s)
- Kathryn Jane Griffin
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK Division of Cardiovascular and Diabetes Research, LIGHT laboratories, Leeds, UK
| | - Simon Cousins
- University of Leeds Medical School, Worsley Building, University of Leeds, UK
| | - Marc Aaron Bailey
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK Division of Cardiovascular and Diabetes Research, LIGHT laboratories, Leeds, UK
| | - David Berridge
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK
| | - David Julian Ashbridge Scott
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK Division of Cardiovascular and Diabetes Research, LIGHT laboratories, Leeds, UK
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Endovenous Laser Ablation of the Great Saphenous Vein Using a Bare Fibre versus a Tulip Fibre: A Randomised Clinical Trial. Eur J Vasc Endovasc Surg 2012; 44:587-92. [DOI: 10.1016/j.ejvs.2012.09.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 09/05/2012] [Indexed: 11/17/2022]
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Success of Endovenous Saphenous and Perforator Ablation in Patients With Symptomatic Venous Insufficiency Receiving Long-Term Warfarin Therapy. Ann Vasc Surg 2012; 26:607-11. [DOI: 10.1016/j.avsg.2011.10.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 08/06/2011] [Accepted: 10/08/2011] [Indexed: 11/22/2022]
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