Browsing by Subject "CONVENTIONAL SURGERY"

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  • Vahaaho, S.; Halmesmaki, K.; Alback, A.; Saarinen, E.; Venermo, M. (2018)
    Background: New treatment methods have challenged open surgery as a treatment for great saphenous vein (GSV) insufficiency, the most common being ultrasound-guided foam sclerotherapy (UGFS) and endovenous laser ablation (EVLA). This study evaluated the long-term results of surgery, EVLA and UGFS in the treatment of GSV reflux. Methods: Patients with symptomatic GSV reflux were randomized to undergo either open surgery, EVLA or UGFS. The main outcome measure was the occlusion rate of the GSV at 5years after operation. Results: The study included 196 patients treated during 2008-2010; of these, 166 (847 per cent) participated in the 5-year follow-up. At 5years, the GSV occlusion rate was 96 (95 per cent c.i. 91 to 100) per cent in the open surgery group, 89 (82 to 98) per cent after EVLA and 51 (38 to 64) per cent after UGFS (P Conclusion: UGFS has significantly inferior occlusion rates compared with open surgery or EVLA, and results in additional treatments.
  • Venermo, Maarit; Saarinen, J.; Eskelinen, Elina; Vähäaho, Sari M; Saarinen, Eva; Railo, Mikael; Uurto, I.; Salenius, J.; Albäck, Anders; Finnish Venous Study Collaborators (2016)
    BackgroundEndovenous ablation techniques and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced open surgery for treatment of great saphenous varicose veins. This was a randomized trial to compare the effect of surgery, endovenous laser ablation (EVLA) (with phlebectomies) and UGFS on quality of life and the occlusion rate of the great saphenous vein (GSV) 12months after surgery. MethodsPatients with symptomatic, uncomplicated varicose veins (CEAP class C2-C4) were examined at baseline, 1month and 1year. Before discharge and at 1week, patients reported a pain score on a visual analogue scale. Preoperative and 1-year assessments included duplex ultrasound imaging and the Aberdeen Varicose Vein Severity Score (AVVSS). ResultsThe study included 214 patients: 65 had surgery, 73 had EVLA and 76 had UGFS. At 1year, the GSV was occluded or absent in 59 (97 per cent) of 61 patients after surgery, 71 (97 per cent) of 73 after EVLA and 37 (51 per cent) of 72 after UGFS (P <0001). The AVVSS improved significantly in comparison with preoperative values in all groups, with no significant differences between them. Perioperative pain was significantly reduced and sick leave shorter after UGFS (mean 1day) than after EVLA (8days) and surgery (12days). ConclusionIn comparison with open surgery and EVLA, UGFS resulted in equivalent improvement in quality of life but significantly higher residual GSV reflux at 12-month follow-up. Foam less effective