Journal of vascular surgery. Venous and lymphatic disorders · 2026
Clinical outcomes and feasibility of nonthermal, nontumescent ablation for isolated below-the-knee great saphenous vein incompetence.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
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Min Jeeyoung, Park Sang Woo, Hwang Jin Ho, Kim Jun Seok, Lee Song Am, Hwang Jae Joon, Chee Hyun Keun, Lee Yun Hak, Yang Woo Young, Kwon Yong Wonn
Аннотация
OBJECTIVE: The aim of this study was to assess feasibility, clinical outcomes, and safety of nonthermal, nontumescent (NTNT) ablation for symptomatic isolated below-the-knee (BTK) great saphenous vein (GSV) incompetence with competent saphenofemoral junction and above-knee GSV.
METHODS: This multicenter retrospective study included 73 treated BTK-GSV limbs in 50 patients who underwent NTNT ablation (mechanochemical ablation or cyanoacrylate adhesive closure) between October 2020 and April 2025. Isolated BTK-GSV incompetence was defined as reflux ≥1.0 second confined to the BTK segment on duplex mapping without junctional or above-knee truncal reflux. Follow-up duplex ultrasound and Venous Clinical Severity Score assessments were performed at 1 week and 1, 3, 6, and 12 months.
RESULTS: Immediate postprocedural duplex ultrasound confirmed complete occlusion of the treated BTK-GSV segment in all limbs. No partial or complete recanalization was observed during follow-up. The median Venous Clinical Severity Score improved significantly from 4 (interquartile range [IQR], 3-4) at baseline (n = 73) to 0 (IQR, 0-1) at 1 week (n = 51), 0 (IQR, 0-1) at 1 month (n = 73), 0 (IQR, 0-1) at 3 months (n = 73), 0 (IQR, 0-0) at 6 months (n = 73), and 0 (IQR, 0-0) at 12 months (n = 43) (all P < .001 vs baseline; Wilcoxon signed-rank test). No major adverse events occurred, including deep vein thrombosis, pulmonary embolism, or permanent paresthesia suggestive of saphenous nerve injury. Minor events included superficial phlebitis (8%), ecchymosis (7%), and skin rash related to bandages or compression stockings (7%), all resolving with conservative management.
CONCLUSIONS: NTNT ablation appears to be a safe and effective option for symptomatic isolated BTK-GSV reflux, providing significant clinical improvement with durable occlusion and without thermal-related nerve injury.
METHODS: This multicenter retrospective study included 73 treated BTK-GSV limbs in 50 patients who underwent NTNT ablation (mechanochemical ablation or cyanoacrylate adhesive closure) between October 2020 and April 2025. Isolated BTK-GSV incompetence was defined as reflux ≥1.0 second confined to the BTK segment on duplex mapping without junctional or above-knee truncal reflux. Follow-up duplex ultrasound and Venous Clinical Severity Score assessments were performed at 1 week and 1, 3, 6, and 12 months.
RESULTS: Immediate postprocedural duplex ultrasound confirmed complete occlusion of the treated BTK-GSV segment in all limbs. No partial or complete recanalization was observed during follow-up. The median Venous Clinical Severity Score improved significantly from 4 (interquartile range [IQR], 3-4) at baseline (n = 73) to 0 (IQR, 0-1) at 1 week (n = 51), 0 (IQR, 0-1) at 1 month (n = 73), 0 (IQR, 0-1) at 3 months (n = 73), 0 (IQR, 0-0) at 6 months (n = 73), and 0 (IQR, 0-0) at 12 months (n = 43) (all P < .001 vs baseline; Wilcoxon signed-rank test). No major adverse events occurred, including deep vein thrombosis, pulmonary embolism, or permanent paresthesia suggestive of saphenous nerve injury. Minor events included superficial phlebitis (8%), ecchymosis (7%), and skin rash related to bandages or compression stockings (7%), all resolving with conservative management.
CONCLUSIONS: NTNT ablation appears to be a safe and effective option for symptomatic isolated BTK-GSV reflux, providing significant clinical improvement with durable occlusion and without thermal-related nerve injury.