Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study).
Details
Serval ID
serval:BIB_6C8CDA72E26F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study).
Journal
Phlebology / Venous Forum of the Royal Society of Medicine
Working group(s)
"Thermal group" for the French Society of Phlebology, the Swiss Society of Phlebology
Contributor(s)
Allouche L., Néaume N., Bammatter JP., Bourgeois L., Bracon JF., Burcheri B., Ravelojaona M., Cales B., Chauzat B., Ducrey N., Gracia S., Gueddi S., Hamel-Desnos C., Desnos P., Hévia M., Kern P., Merminod T., Ouvry P., Poulain C., Sintes P., Lampel M., Thiên QT.
ISSN
1758-1125 (Electronic)
ISSN-L
0268-3555
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
30
Number
8
Pages
525-532
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
OBJECTIVES: To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years).
METHOD: An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher.
RESULTS: EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0-10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10).
CONCLUSION: TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.
METHOD: An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher.
RESULTS: EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0-10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10).
CONCLUSION: TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.
Keywords
Aged, Aged, 80 and over, Catheter Ablation/adverse effects, Catheter Ablation/methods, Female, Humans, Laser Therapy/adverse effects, Laser Therapy/methods, Male, Middle Aged, Prospective Studies, Saphenous Vein/surgery, Venous Insufficiency/surgery
Pubmed
Web of science
Create date
22/09/2015 17:25
Last modification date
20/08/2019 15:26