Document Detail


Predictive factors of success following radio-frequency stylet (RFS) ablation of incompetent perforating veins (IPV).
MedLine Citation:
PMID:  19576715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate potential predictive factors associated with success or failure of incompetent perforating veins (IPVs) treated with radio-frequency stylet (RFS).
METHODS: Over the last 12 months in this observational study, 38 consecutive patients with various degrees of venous insufficiency and IPVs underwent 48 office-based radio-frequency ablation procedures (1 - C 3; 7 - C 4; 10 - C 5; 30 - C 6) in 44 limbs. There were 21 females and 17 males with a mean age of 67 +/- 17 years (38-93 years) who had a total of 93 IPVs (40 calf; 53 ankle). Eighteen patients (47%) had ipsilateral great saphenous vein (GSV) radio-frequency closures performed prior to current procedure. The venous flow pattern was classified by spectral waveform analysis as "normal" (spontaneous with respiratory phasicity) in 33 patients and "pulsatile" (with bidirectional cardiac phasicity) in five patients. Follow-up duplex scans were performed from 3 to 7 days postprocedure. Statistical analyses were performed for determining correlation between the various factors such as, age, pulsatile flow, CEAP class, prior GSV ablation, vein diameter, reflux, and patency.
RESULTS: The mean number of ablated IPVs was 1.94 +/- 0.38 ranging from 1-3. Immediate success rate was 88% (82 cases, 32 patients). IPVs had a duplex measured mean diameter of 3.8 +/- 1.1 mm (2-6.6 mm). Eleven IPVs remained patent in six patients. There was no significant difference between the patent and the obliterated IPV groups concerning age (P = 0.75), prior GSV ablation (P = .19), IPV diameter (P = .08) and CEAP classification. Conversely, four of the five procedures (80%) performed in patients with "pulsatile" venous flow failed, while only two of the remaining 43 procedures (4.7%) in patients with "normal" venous flow failed (P < .001).
CONCLUSION: These data show that a pulsatile venous flow pattern is a significant predictor of failure following RFS for IPVs.
Authors:
Anil P Hingorani; Enrico Ascher; Natalie Marks; Alexander Shiferson; Nirav Patel; Kapil Gopal; Theresa Jacob
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Publication Detail:
Type:  Journal Article     Date:  2009-07-03
Journal Detail:
Title:  Journal of vascular surgery     Volume:  50     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-29     Completed Date:  2009-10-15     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  844-8     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA. ahingorani@maimonidesmed.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
Blood Flow Velocity / physiology
Catheter Ablation / methods*
Chronic Disease
Cohort Studies
Female
Follow-Up Studies
Humans
Logistic Models
Male
Middle Aged
Monitoring, Intraoperative / methods
Multivariate Analysis
Predictive Value of Tests
Probability
Risk Assessment
Saphenous Vein*
Severity of Illness Index
Treatment Outcome
Ultrasonography, Doppler, Duplex
Venous Insufficiency / physiopathology,  surgery*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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