Objectives: Endovenous thermal ablation (EVTA) is the first-line treatment for varicose veins. Many in-vitro models have been made to study the effects of EVTA on the vein wall. Models using explanted human great saphenous vein (GSV) use anticoagulated blood passed into the vein during treatment, either static or being pumped to simulate “physiological flow”. The objective of this study was to investigate whether there is any evidence that there is actually any blood in GSVs being treated by EVTA.
Methods: 9 consecutive patients (11 GSV’s) had their intraluminal GSV diameters measured with ultrasound on standing, lying, 10° head down (Trendelenburg position) and 10° head down with tumescence and an endovenous laser device within the vein. The size of the vein lumen was noted and the vein interrogated longitudinally with colour duplex ultrasound to look for any venous flow.
Results: There was a progressive reduction of luminal diameter from standing to lying 10° head down. When 10° head down with a 4FG endovenous laser device in position and tumescence around the vein, 10 of the 11 GSVs showed no lumen at all and 1 showed a very minor “out-pouching” on one side of the device at one level, which did not communicate with any lumen above or below, and showed no flow.
Results: There was a progressive reduction of luminal diameter from standing to lying 10° head down. When 10° head down with a 4FG endovenous laser device in position and tumescence around the vein, 10 of the 11 GSVs showed no lumen at all and 1 showed a very minor “out-pouching” on one side of the device at one level, which did not communicate with any lumen above or below, and showed no flow.
Whiteley, M. S., & Fernandez-Hart, T. J. (2023, April 4). Veins undergoing endovenous thermal ablation have little or no blood intra-luminally casting doubt on the results of many ex-vivo vein ablation studies. https://doi.org/10.31219/osf.io/vef4m
Leave a Reply