Laser, Quality of Life, Varicose Veins
Conditions
Brief summary
Endovenous laser thermoablation is a well-established alternative for the treatment of tributary veins. We believe that it is possible to improve the techniques described in the literature, aiming not only to allocate the laser fiber within the venous lumen, but mainly to transfix the vessel walls - a technique called TEThA (Transfixing Endovenous Thermal Ablation).
Detailed description
Endovenous laser thermoablation is an alternative for the treatment of tributary veins that is not yet one of the main alternatives in our specialty's consensus. In order to treat tributary veins applying laser, several punctures and the complete placement of introducer catheters are recommended in order to position the endolaser fiber in the lumen of the varicose vein before performing thermoablation of the saphenous veins. However, we believe that it is possible to perform an adequate treatment with a smaller number of punctures, aiming not only to place the laser fiber inside the venous lumen, but mainly to transfix the vessel walls - a technique called TEThA (Transfixing Endovenous Thermal Ablation). Our aim is to carry out a prospective cohort study to assess the Aberdeen score in patients undergoing the TEThA technique for the treatment of tributary veins.
Interventions
PROCEDURETEThA technique
Patient in an orthostatic position, previously marked varicose veins will be punctured with a tracing adjacent to them, surrounding their edges. Applying an augmented reality device and Doppler ultrasound (Doppler USG), the marking will be complemented in the supine position. These punctures will in turn be carried out using the TEThA technique - endovenous thermoablation of tributary veins by means of transfixation - and will be done sequentially as they are treated one by one with endo- and perivenous thermoablation under generous tumescence with 0.08% lidocaine in saline solution. The laser used to treat the tributary veins will also be 1470 nm and will be fired as the fiber is removed at a speed of 1 mm/sec and power ranging from 5 to 7 watts.
Sponsors
Gabriela de Oliveira Buril
Marcelo Halfen Grill
Nara Medeiros Cunha de Melo Vasconcelos
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Patients with varicose veins \> 2mm associated with reflux of great or small saphenous veins with CEAP C2 to C6
Exclusion criteria
Patients under 18 years Acute or previous thrombophlebitis or deep vein thrombosis. Pregnant patient. Reject the Informed Consent Form.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of Life score using Aberdeen Varicose Veins Questionnaire (AVVQ) | Baseline, Timepoints post-procedire: 1 month, 3 months, 6 months | AVVQ is an easy-to-administer, self-administered instrument, it consists of 3 dimensions, which are physical, sociofunctional and psychological. It is interpreted through a score, which can vary between 0 and 100, with 0 representing no evidence of varicose veins and 100 the most serious problem associated with varicose veins. |
| Quality of life score using the Chronic Venous Insufficiency Questionnaire (CIVIQ) | Timepoints post-procedire: 1 month, 3 months, 6 months | CIVIQ-14 is a questionnaire based on three dimensions - pain, physical and psychological, based on a scale from 1 to 5 (no trouble, slight, moderate, considerable, severe). Based on inputs, Global Index Score (GIS) will be tabulated, ranging from 0 to 100 - the higher the value, the poorer the quality of life. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Presence of induration | 30 days and 180 days | Induration noticed on the saphenous vein path (phototodocumentation, US Doppler) |
| Presence of Paresthesia | 30 days and 180 days | Presence or absence of paresthesia in the limb treated by endovenous laser TEThA technique |
| Sclerothrombus | 7 days | Presence of Sclerothrombus (US doppler) |
| Lymphedema | 30 days and 180 days | Presence or absence of lymphedema diagnosed by exam of lymphoscintigraphy in the limb treated by endovenous laser TEThA technique |
| Complementary treatment | 180 days | Percentage of participants with residual veins |
| Skin burns | 7 days | Presence or absence of skin burns in the limb treated by a endovenous laser with TEThA technique |
| Hyperpigmentation | Baseline, 30 days and 180 days | Presence or absence of hyperpigmentation in the limb treated by a endovenous laser with TEThA tecnique (phototodocumentation, US Doppler) |
Contacts
Primary ContactEduardo Ramacciotti, MD, PhD
Outcome results
None listed