26. EVALUATION OF EARLY RESULTS OF ENDOVENOUS LASER TREATMENT FOR INFERIOR EXTREMITY SUPERFICIAL VENOUS INSUFFICIENCY AT QUANG NAM CENTRAL GENERAL HOSPITAL
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Abstract
Background: Varicose veins of the lower limbs is a common disease. The disease greatly affects the patient's aesthetics and quality of life. At Quang Nam Central General Hospital, treatment of superficial lower limb venous insufficiency with endovenous LASER ablation was performed for the first time in November 2019. Up to now, this treatment method has gradually become more popular.
Objective: Evaluate early results (after 4 weeks) of treating superficial lower limb venous insufficiency with endovenous LASER ablation.
Subjects and methods: Prospective intervention. The study will be conducted in 18 months (May 2022-October 2023). All patients meeting for selection criterion were treated with endovenous LASER ablation. Evaluating results after 4 weeks through clinical examination to evaluate symptom improvement and venous Doppler ultrasound to check embolization effectiveness, and evaluating complications of treatment.
Results: The median length of the great saphenous vein segment treated with endovascular LASER was 42 cm. The length of the small saphenous vein lasered is 18 cm. The average LASER energy used in the study for the treatment of greater saphenous vein insufficiency was 61.99 ± 5.63 J/cm, for the small saphenous vein it was 68.3 J/cm. Change in CEAP-C clinical grading after intravascular LASER: CEAP-C2 decreased from 61.8% to 14.7%; CEAP-C3 decreased from 11.8% to 0%; CEAP-C4a decreased from 14.7% to 5.9%; CEAP-C4c decreased from 11.8% to 2.9%. The median VCSS score after intervention decreased by 3 points compared to before intervention, this difference is statistically significant. Vein diameter after intervention decreased statistically significantly compared to before intervention (from 5.86 mm before intervention to 3 mm after intervention). After intervention, all saphenous veins treated with endovascular LASER were completely occluded and had no flow. The most common complications after endovenous LASER intervention are pain along the vein path (88.2%) and bruising along the LASER vein path (67.6%). These complications are usually mild and recover quickly.
Conclusion: Endovenous LASER is a safe, effective, and aesthetic treatment method for superficial varicose veins of the lower limbs.
Article Details
Keywords
LASER nội tĩnh mạch
References
[2] Nguyễn Trung Anh, Nghiên cứu đặc điểm lâm sàng, cận lâm sàng, kết quả điều trị suy tĩnh mạch chi dưới mạn tính của phương pháp gây xơ bằng thuốc và LASER nội tĩnh mạch, Luận án tiến sỹ y học, Viện Nghiên cứu khoa học Y Dược lâm sàng 108, 2017.
[3] Bộ Y tế, Điều trị suy tĩnh mạch bằng LASER nội mạch, Hướng dẫn quy trình kỹ thuật nội khoa chuyên ngành tim mạch, 2014, tr. 242-245.
[4] Hồ Khánh Đức, Đinh Hoài Thanh và CS, Điều trị suy tĩnh mạch nông chi dưới bằng phương pháp LASER nội tĩnh mạch: kết quả sau 2 năm theo dõi, Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 2014, tr. 12-20.
[5] Lê Nguyễn Quyền, Trịnh Quốc Minh, Đánh giá kết quả sớm điều trị suy tĩnh mạch nông chi dưới mạn tính bằng LASER nội tĩnh mạch tại Bệnh viện Trưng Vương, Tạp chí Y học thành phố Hồ Chí Minh, 2018, tập 22, số 6, tr. 55-60.
[6] Cao Văn Thịnh, Dương Văn Mười Một, Kết quả bước đầu điều trị suy tĩnh mạch mạn, giãn tĩnh mạch dưới da chi dưới bằng LASER nội tĩnh mạch tại Bệnh viện nhân dân 115 thành phố Hồ Chí Minh, Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 2014, số 8, tr. 45-52.
[7] Eberhardt Robert T, Raffetto Joseph D, Chronic venous insufficiency, Circulation, 2014, 130(4), pp. 333-346.
[8] Ravi Rajagopalan, Trayler Edwina A et al, Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period, Journal of Endovascular Therapy, 2009, 16(4), pp. 500-505.
[9] Vähäaho S, Mahmoud O et al, Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins, Journal of British Surgery, 2019, 106(5), pp. 548-554.
[10] Van den Bos Renate, Arends Lidia et al, Endovenous therapies of lower extremity varicosities: a meta-analysis, Journal of vascular Surgery, 2009, 49(1), pp. 230-239.
[11] Wittens Cees, Davies AH et al, Editor's choice-management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS), European Journal of Vascular and Endovascular Surgery, 2015, 49(6), pp. 678-737.