Subscribe to RSS
DOI: 10.1055/a-0648-0021
Endovenöse Behandlungsverfahren der Varikosis und der chronisch-venösen Insuffizienz
Endovenous Treatment of Varicose Veins and Chronic Venous InsufficiencyPublication History
Publication Date:
04 June 2019 (online)
![](https://www.thieme-connect.de/media/dmw/201911/lookinside/thumbnails/dmw-6480021_10-1055-a-0648-0021-1.jpg)
Was ist neu?
Endovenöse Lasertherapie Verfahren mit längeren Wellenlängen und/oder modifizierten Lichtleitern sollten bevorzugt werden.
Radiofrequenzobliteration 5-Jahres-Ergebnisse zeigen eine sehr gute Effektivität.
Weitere endovenöse, nicht thermische Verfahren Es liegen noch nicht sehr viele Daten vor. Die publizierten Studien zeigen eine gute Effektivität der Methoden.
Nachbeobachtungen Die bisher publizierten Daten mit Vergleich der operativen und endovaskulären Methoden im 5-Jahres-Follow-up sind nur mit Einschränkungen aussagekräftig und teils schon durch technische Weiterentwicklungen überholt.
Abstract
Endovenous laser ablation Treatment with longer wavelengths and radial fibers should be used.
Radiofrequency ablation Results after 5 years show a very good efficacy and safety.
Further endovenous treatments Data is limited. The short-term studies show a good efficacy of nonthermal ablation methods.
Follow-up studies There is no data about a 10 year follow-up until now. Data with comparison of surgical and endovenous therapy show after 5 years show more sonographical reflux in patients treated with first generation endothermal treatment without any differences in the clinical outcome.
-
Literatur
- 1 Brittenden J, Cotton SC, Elders A. et al. A randomized trial comparing treatments for varicose veins. N Engl J Med 2014; 371: 1218-1227
- 2 Doganci S, Demirkilic U. Comparison of 980 nm Laser and Bare-tip Fibre with 1470 nm Laser and Radial Fibre in the Treatment of Great Saphenous Vein Varicosities: A Prospective Randomised Clinical Trial. Eur J Vasc Endovasc Surg 2010; 40: 254-259
- 3 Lawson JA, Gauw SA, van Vlijmen CJ. et al. Prospective comparative cohort study evaluating incompetent great saphenous vein closure using radiofrequency-powered segmental ablation or 1470-nm endovenous laser ablation with radial-tip fibers (Varico 2 study). J Vasc Surg Venous Lymphat Disord 2018; 6: 31-40
- 4 Van der Velden SK, Lawaetz M, De Maeseneer MG. et al. Predictors of Recanalization of the Great Saphenous Vein in Randomized Controlled Trials 1 Year After Endovenous Thermal Ablation. Eur J Vasc Endovasc Surg 2016; 52: 234-241
- 5 Gibson K, Khilnani N, Schul M. et al. American College of Phlebology Guidelines – Treatment of refluxing accessory saphenous veins. Phlebology 2017; 32: 448-452
- 6 Proebstle TM, Alm BJ, Göckeritz O. et al. Five year results from the prospective European multicenter cohort study on radiofrequency segmental thermal ablation for incompetent great saphenous veins. Br J Surg 2015a 102: 212-218
- 7 Lawaetz M, Serup J, Lawaetz B. et al. Comparison of endovenous ablation techniques, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Extended 5-year follow-up of a RCT. Int Angiol 2017; 36: 281-218
- 8 Witte ME, Reijnen MM, de Vries JP. et al. Mechanochemical Endovenous Occlusion of Varicose Veins Using the ClariVein® Device. Surg Technol Int 2015; 26: 219-225
- 9 Gibson K, Morrison N, Kolluri R. et al. Twenty-four month results from a randomized trial of cyanoacrylate closure versus radiofrequency ablation for the treatment of incompetent great saphenous veins. J Vasc Surg Venous Lymphat Disord 2018; 6: 606-613
- 10 Morrison N, Gibson K, Vasquez M. et al. VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins. J Vasc Surg Venous Lymphat Disord 2017; 5: 321-330
- 11 Chan YC, Law Y, Cheung GC. et al. Cyanoacrylate glue used to treat great saphenous reflux: Measures of outcome. Phlebology 2017; 32: 99-106
- 12 Gibson K, Ferris B. Cyanoacrylate closure of incompetent great, small and accessory saphenous veins without the use of post-procedure compression: Initial outcomes of a post-market evaluation of the VenaSeal System (the WAVES Study). Vascular 2017; 25: 149-156
- 13 Rass K, Frings N, Glowacki P. et al. Same Site Recurrence is More Frequent After Endovenous Laser Ablation Compared with High Ligation and Stripping of the Great Saphenous Vein: 5 year Results of a Randomized Clinical Trial (RELACS Study). Eur J Vasc Endovasc Surg 2015; 50: 648-656
- 14 Kheirelseid EAH, Crowe G, Sehgal R. et al. Systematic review and meta-analysis of randomized controlled trials evaluating long-term outcomes of endovenous management of lower extremity varicose veins. J Vasc Surg Venous Lymphat Disord 2018; 6: 256-270
- 15 Gauw SA, Lawson JA, van Vlijmen-van Keulen CJ. et al. Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. J Vasc Surg 2016; 63: 420-428
- 16 Hamann SAS, Giang J, De Maeseneer M. et al. Five Year Results of Great Saphenous Vein Treatment: A Meta-analysis. Eur J Vasc Endovasc Surg 2017; 54: 760-770