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Neuste Ergebnisse der endovenösen thermischen Verfahren in der Behandlung der Varikose

Updated results of endovenous thermal procedures in the treatment of varicose veins

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Zusammenfassung

Die endovenösen thermischen Verfahren sind seit 1998 (Radiofrequenzobliteration) bzw. 1999 (endovenöse Lasertherapie) zur Behandlung der Varikose in Europa zugelassen. Beide endovenöse thermische Therapieverfahren werden heute als etablierte Behandlungsoptionen angesehen. Bei der endovenösen Lasertherapie stehen Wellenlängen von 810 nm bis 1500 nm zur Therapie zur Verfügung, wobei in den letzten Jahren ein Trend zur höheren Wellenlängen zu verzeichnen ist. Das Faserdesign wurde von der Bare Fiber zur radial abstrahlenden Laserlichtleitern geändert, was zu einer geringeren perioperativen Komplikationsrate geführt hat. Auch bei der Radiofrequenzobliteration haben sich in den letzten Jahren technische Änderungen ergeben, insbesondere vom kontinuierlichen Rückzug zur segmentalen Ablation der Vene bei höheren Temperaturen (VNUS Closure Fast™). Diese Änderungen haben zu einer deutlichen Verbesserung der Verschlussrate bei gleich niedriger perioperativer Komplikationsrate geführt.

Abstract

Endovenous thermal procedures have been approved for the treatment of varicose veins since 1998 (radiofrequency ablation) and 1999 (endovenous laser therapy). Both endovenous thermal therapy procedures are now well established treatment options. For endovenous laser therapy wavelengths from 810 nm to 1500 nm are used with a recent trend to higher wavelengths. The fibre design was changed from bare fibres to radially radiating laser fibers, which led to lower perioperative complication rates. Technical changes have also recently occurred in radiofrequency obliteration, especially from continuous withdrawal to segmental ablation of veins with higher temperatures (VNUS Closure Fast™). These alterations have led to a clear improvement in closure rates with lower perioperative complication rates.

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Literatur

  1. Almeida J, Kaufman J, Göckeritz O et al (2009) Radiofrequency endovenous Closure Fast versus laser ablation for the treatment of great saphenous reflux: A multicenter, single-blinded, randomized study (Recovery Study). J Vasc Interv Radiol 20:752–759

    Article  PubMed  Google Scholar 

  2. Boon R, Akkersdijk GJ, Nio D (2010) Percutaneous treatment of varicose veins with bipolar radiofrequency ablation. Eur J Radiol 75:43–47

    Article  PubMed  CAS  Google Scholar 

  3. Bos RR van den, Arends L, Kockaert M et al (2009) Endovenous therapies of lower extremity varicosities: A meta-analysis. J Vasc Surg 49:230–239

    Article  PubMed  Google Scholar 

  4. Camci M, Harnoss B, Akkerskijk G et al (2009) Effectiveness and tolerability of bipolar radiofrequency-induced thermotherapy for the treatment of incompetent saphenous veins. Phlebologie 38:5–11

    Google Scholar 

  5. Carradice D, Mekako AI, Mazari FA et al (2011) Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg (Epub ahead of print)

  6. Christenson JT, Gueddi S, Gemayel G, Bounameaux H (2010) Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up. J Vasc Surg 52:1234–1241

    Article  PubMed  Google Scholar 

  7. Darwood RJ, Theivacumar N, Dellagrammaticas D et al (2008) Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary saphenous varicose veins. Br J Surg 95:294–301

    Article  PubMed  CAS  Google Scholar 

  8. Disselhoff BCVM, Kinderen DJ der, Delder JC et al (2008) Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins. Br J Surg 95:1232–1238

    Article  PubMed  CAS  Google Scholar 

  9. Disselhoff BC, Kinderen DJ der, Kelder JC, Moll FL (2011) Five-years results of a randomised clinical trial of endovenous laser ablation of the great saphenous vein with and without ligation of the saphenofemoral junction. Eur J Vasc Endovasc Surg (Epub ahead of print)

  10. Doganci S, Demirkilic U (2010) Comparison of 980 nm laser and bare fiber with 1470 nm laser and radial fiber in the treatment of great saphenous vein varicosities: a prospective randomised clinical trial. Eur J Vasc Endovasc Surg 40:254–259

    Article  PubMed  CAS  Google Scholar 

  11. Kalteis M, Berger I, Messie-Werndl S et al (2008) High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: Early results of a randomized controlled study. J Vasc Surg 47:822–829

    Article  PubMed  Google Scholar 

  12. Kaspar S, Pirkl M, Priborská J et al (2009) A six-year experience with endovenous laser in the treatment of lower extremity varices. Rozhl Chir 88:106–114

    PubMed  CAS  Google Scholar 

  13. Luebke T, Gawenda M, Heckenkamp J et al (2008) Metaanalysis of endovenous radiofrequency obliteration of the great saphenous vein in primary varicosis. J Endovasc Ther 15:213–223

    Article  PubMed  Google Scholar 

  14. Noppeney T, Kluess H et al (2010) Leitlinie zur Diagnostik und Therapie des Krampfaderleidens Gefässchirurgie 15:473–476

  15. Noppeney T, Noppeney J, Winkler M (2008) Update der Ergebnisse nach Radiofrequenzobliteration zur Ausschaltung der Varikose. Gefässchirurgie 13:258–264

    Article  Google Scholar 

  16. Pannier F, Rabe E, Rits J et al (2011) Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre; follow-up-after six months. Phlebology 26:35–39

    Article  PubMed  CAS  Google Scholar 

  17. Pannier F, Rabe E, Maurins U (2010) 1470 nm diode laser for endovenous ablation (EVLA) of incompetent saphenous veins – a prospective randomized pilot study comparing warm and cold tumenscence anaesthesia. Vasa 39:249–255

    PubMed  Google Scholar 

  18. Pannier F, Rabe E (2008) Mid-term results following endovenous laser ablation (EVLA) of saphenous veins with a 980 nm diode laser. Int Angiol 27:475–481

    PubMed  CAS  Google Scholar 

  19. Pröbstle TM, Alm J, Göckeritz O et al (2011) Three-year European follow-up of endovenous radiofrequency-powered segmental thermal ablation of the great saphenous vein with or without treatment of calf varicosities. J Vasc Surg [Epub ahead of print]

  20. Pröbstle T, Vago B, Alm J et al (2008) Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: First clinical experience. J Vasc Surg 47:151–156

    Article  Google Scholar 

  21. Rasmussen LH, Bjoern L, Lawaetz M et al (2010) Randomised clinical trial comparing endovenous laser ablation with stripping of the great saphenous vein: clinical outcome and recurrence after 2 years. Eur J Vasc Endovasc Surg 39:630–635

    Article  PubMed  CAS  Google Scholar 

  22. Rathod J, Taori K, Joshi M et al (2010) Outcomes using a 1470-nm laser for symptomatic varicose veins. J Vasc Interv Radiol 21:1835–1840

    Article  PubMed  Google Scholar 

  23. Ravi R, Trayler EA, Barrett DA, Diethrich EB (2009) Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period. J Endovasc Ther 16:500–505

    Article  PubMed  Google Scholar 

  24. Schmedt CG, Sroka R, Steckmeier S et al (2006) Investigation on radiofrequency and laser (980 nm) effects after endoluminal treatment of saphenous vein insufficiency in an ex-vivo model. Eur J Vasc Endovasc Surg 32:318–325

    Article  PubMed  Google Scholar 

  25. Schmedt CG, Sroka R, Sadeghi M et al (2010) Neue Entwicklungen der endovenösen Lasertherapie. Gefässchirurgie 15:125–132

    Article  Google Scholar 

  26. Schwarz T, Hodenberg F, Furtwängler C von et al (2010) Endovenous laser ablation of varicose veins with the 1470 nm diode laser. J Vasc Surg 51:1474–1478

    Article  PubMed  Google Scholar 

  27. Sharifi M, Mehdipiur M, Bay C et al (2011) Effect of anticoagulation on endothermal ablation of the great saphenous vein. J Vasc Surg 53:147–149

    Article  PubMed  Google Scholar 

  28. Shepherd AC, Gohel MS, Lim CS et al (2010) Pain following 980-nm endovenous laser ablation and segmental radiofrequency ablation for varicose veins: a prospective observational study. Vasc Endovasc Surg 44:212–216

    Article  Google Scholar 

  29. Spreafico G, Kabnick L, Berland TL et al (2011) Laser saphenous ablations in more than 1,000 limbs with long-term duplex examination follow-up. Ann Vasc Surg 25:71–78

    Article  PubMed  Google Scholar 

  30. Sroka R, Weick K, Dadghi-Azandaryani M et al (2010) Endovenous laser therapy- application studies and latest investigations. J Biophotonics 3:269–276

    Article  PubMed  Google Scholar 

  31. Subramonia S, Lees T (2010) Randomized clinical trial of radiofrequency ablation or conventional high ligation and stripping for great saphenous varicose veins. Br J Surg 97:328–336

    Article  PubMed  CAS  Google Scholar 

  32. Vuylsteke M, Dorpe J, Van Roelens J et al (2010) Intraluminal fibre-tip centring can improve endovenous laser ablation: a histological study. Eur J Vasc Endovasc Surg 40:110–116

    Article  PubMed  CAS  Google Scholar 

  33. Zierau UT, Lahl W (2009) The endovenous RFITT treatment of varicose veins, a new method of interventional phlebology. Technique and first results. Phlebologie 38:12–16

    Google Scholar 

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Der Autor ist Consultant der Firma Covidien.

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  1. Versorgungszentrum für Gefäßmedizin, Obere Turnstr. 8, 90429, Nürnberg, Deutschland

    T. Noppeney & H. Nüllen

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  1. T. Noppeney
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  2. H. Nüllen
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Correspondence to T. Noppeney.

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Noppeney, T., Nüllen, H. Neuste Ergebnisse der endovenösen thermischen Verfahren in der Behandlung der Varikose. Gefässchirurgie 16, 242–247 (2011). https://doi.org/10.1007/s00772-011-0901-7

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