Endovenous welding: Basics and 5-year experience in the use of automatic thermal ablation in the treatment of patients with chronic vein diseases

Abstract

Objectives

We proposed a method of endovenous welding (EVW) in which automatic ablation mode is implemented. The results of clinical studies in short follow-up periods, which were published earlier, showed a high level of effectiveness and safety of EVW.

Aims

To analyze the results of the use of EVW in the treatment of patients with CVD in different terms of follow-up.

Methods

The 5-year results of 236 cases of EVW use in 184 consecutive patients with CVD C2–C6 (48 men, 136 women, aged 21 to 74 years) with ostial diameters from 5.7 to 31 mm were studied. EW was performed using EK 300M generator and welding catheters (Svarmed, Ukraine) in accordance with mini-invasive methodology. The results were evaluated according to the ultrasound data, the level of postoperative pain (РР), complications.

Results

After the intervention and in the following 6 months and 12 months, successful ablation was noted in 100% of cases. In the next 4 years, no cases of recanalization were noted. In 38 cases (16.1%) progression of the disease was observed as a result of reflux in the previously unchanged veins. Absence of PP was noted in 85.6% of cases, in 14.4% PP did not exceed a moderate level. Serious complications were not detected.

Conclusions

EVW is an effective alternative to other thermal methods with a better control algorithm. The automatic welding mode allows to eliminate the influence of subjective factors on the treatment results and significantly reduce the risk of recanalization and complications. The characteristics of EVW expand the possibilities of using thermal ablation in patients with severe forms of CVD with veins of large diameter, their extrafascial location, as well as in patients with incompetent venous trunks below the knee.