Document Detail


The impact of ablation of incompetent superficial and perforator veins on ulcer healing rates.
MedLine Citation:
PMID:  22133452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We assessed the impact of endovenous ablation of incompetent superficial (great saphenous [GSV] and small saphenous [SSV]) and perforator (posterior tibial [PTPV]) veins on the healing rate of venous ulcers in patients who had failed conventional compression therapy.
METHODS: Patients with CEAP 6 ulcers were treated with weekly compression in a dedicated wound care center. Ulcer size and depth were tracked prospectively. Those ulcers that showed no measurable improvement after >5 weeks of compression therapy underwent ablation of at least one incompetent vein.
RESULTS: We performed 140 consecutive endovenous ablation procedures (74 superficial and 66 perforator) on 110 venous ulcers in 88 limbs. Ulcers had been present for 71 ± 6 months with an initial ulcer area of 23 ± 6 cm(2). Following successful ablation, the healing rate for healed ulcers improved from + 1.0 ± .1 cm(2)/month to -4.4 ± .1 cm(2)/month (P > .05). Ulcer healing rate for healed ulcers, based on the last vein ablated, was GSV = 6.4 cm(2)/month, SSV = 4.8 cm(2)/month, and PTPV = 2.9 cm(2)/month. After a minimum observation period of 6 months (mean follow up, 12 ± 1.25 months), 76.3% of patients healed in 142 ± 14 days. Twelve patients with 26 ulcers did not heal: two patients died from unrelated illnesses, six patients are still actively healing, and four patients have been lost to follow up. Of the healed ulcers, four patients with six ulcers (7.1%) recurred; two have rehealed.
CONCLUSION: There is measurable and significant reduction in ulcer size and ultimate healing following ablation of incompetent superficial and perforator veins in patients who have failed conventional compression therapy.
Authors:
Michael Harlander-Locke; Peter F Lawrence; Ali Alktaifi; Juan Carlos Jimenez; David Rigberg; Brian DeRubertis
Publication Detail:
Type:  Journal Article     Date:  2011-12-01
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  2012-03-12     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:  458-64     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
University of San Diego, San Diego, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Ablation Techniques*
Aged
Chi-Square Distribution
Female
Humans
Kaplan-Meier Estimate
Los Angeles
Male
Pressure
Prospective Studies
Recurrence
Saphenous Vein / pathology,  surgery*
Severity of Illness Index
Time Factors
Treatment Outcome
Varicose Ulcer / pathology,  surgery*
Varicose Veins / pathology,  surgery*
Wound Healing*

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


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