Cornelis G Vos1, Çağdaş Ünlü2, Jan Bosma3, Clarissa J van Vlijmen4, A Jorianne de Nie2, Michiel A Schreve2. 1. Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands. Electronic address: ncgvos@gmail.com. 2. Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands. 3. Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. 4. Department of Surgery, Centrum Oosterwal, Alkmaar, The Netherlands.
Abstract
BACKGROUND: Endothermal treatment of the great saphenous vein (GSV) has become the first-line treatment for superficial venous reflux. Nonthermal ablation has potential benefits for acceptability by patients and decreased risk of nerve injury. We performed a systematic review and meta-analysis to evaluate the efficacy of mechanochemical endovenous ablation (MOCA) and cyanoacrylate vein ablation (CAVA) for GSV incompetence. METHODS: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases were searched for papers published between January 1966 and December 2016. Eligible articles were prospective studies that included patients treated for GSV incompetence and described the primary outcome. Exclusion criteria were full text not available, case reports, retrospective studies, small series (n < 10), reviews, abstracts, animal studies, studies of small saphenous vein incompetence, and recurrent GSV incompetence. Primary outcome was anatomic success. Secondary outcomes were initial technical success, Venous Clinical Severity Score, Aberdeen Varicose Vein Questionnaire score, and complications. RESULTS: Fifteen articles met the inclusion criteria. Pooled anatomic success for MOCA and CAVA was 94.7% and 94.8% at 6 months and 94.1% and 89.0% at 1 year, respectively. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire score significantly improved after treatment with MOCA and CAVA. CONCLUSIONS: These results are promising for these novel techniques that could serve as alternatives for thermal ablation techniques. However, to determine their exact role in clinical practice, high-quality randomized controlled trials comparing these novel modalities with well-established techniques are required.
BACKGROUND: Endothermal treatment of the great saphenous vein (GSV) has become the first-line treatment for superficial venous reflux. Nonthermal ablation has potential benefits for acceptability by patients and decreased risk of nerve injury. We performed a systematic review and meta-analysis to evaluate the efficacy of mechanochemical endovenous ablation (MOCA) and cyanoacrylate vein ablation (CAVA) for GSV incompetence. METHODS: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases were searched for papers published between January 1966 and December 2016. Eligible articles were prospective studies that included patients treated for GSV incompetence and described the primary outcome. Exclusion criteria were full text not available, case reports, retrospective studies, small series (n < 10), reviews, abstracts, animal studies, studies of small saphenous vein incompetence, and recurrent GSV incompetence. Primary outcome was anatomic success. Secondary outcomes were initial technical success, Venous Clinical Severity Score, Aberdeen Varicose Vein Questionnaire score, and complications. RESULTS: Fifteen articles met the inclusion criteria. Pooled anatomic success for MOCA and CAVA was 94.7% and 94.8% at 6 months and 94.1% and 89.0% at 1 year, respectively. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire score significantly improved after treatment with MOCA and CAVA. CONCLUSIONS: These results are promising for these novel techniques that could serve as alternatives for thermal ablation techniques. However, to determine their exact role in clinical practice, high-quality randomized controlled trials comparing these novel modalities with well-established techniques are required.
Authors: Piotr Terlecki; Marek Boryga; Paweł Kołodziej; Krzysztof Gołacki; Zbigniew Stropek; Dariusz Janczak; Maciej Antkiewicz; Tomasz Zubilewicz Journal: Materials (Basel) Date: 2022-04-01 Impact factor: 3.623
Authors: Ahmet Barış Durukan; Esin Akbay; Ahmet Ünlü; Ayşe Özdemir; Mehmet Ali Onur Onur Journal: Turk Gogus Kalp Damar Cerrahisi Derg Date: 2019-04-24 Impact factor: 0.332