COST-EFFECTIVENESS OF RADIOFREQUENCY ABLATION VERSUS LASER FOR VARICOSE VEINS.

Objectives: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial.

Methods: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness.

Ambulatory varicosity avulsion later or synchronized (AVULS): a randomized clinical trial.

Objective: A randomized clinical trial assessing the difference in quality of life and clinical outcomes between delayed and simultaneous phlebectomies in the context of endovenous truncal vein ablation.

Background: Endovenous ablation has replaced open surgery as the treatment of choice for truncal varicose veins. Timing of varicosity treatment is controversial with delayed and simultaneous pathways having studies advocating their benefits.

Pathogenesis and etiology of recurrent varicose veins.

Background: Recurrent varicose veins (RVV) occur in 13% to 65% of patients following treatment, and remain a debilitating and costly problem. RVV were initially thought largely to be due to inadequate intervention, however, more recently neovascularization and other factors have been implicated. This review aims to provide an overview of the current understanding of the etiology and pathogenesis of RVV.

Neurological complications of sclerotherapy for varicose veins.

Background: Sclerotherapy has been shown to be an effective and increasingly popular therapeutic strategy for the treatment of varicose veins. However, recent reports of serious side effects, including cerebrovascular accidents (CVA) and transient ischemic attacks (TIA), as well as speech and visual disturbances, have caused serious concern regarding its use. This review evaluated the reported incidences of neurological side effects associated with the use of sclerotherapy.

A study to compare disease-specific quality of life with clinical anatomical and hemodynamic assessments in patients with varicose veins.

Objective: The wide variety of outcome measures to evaluate patients with varicose veins poses significant difficulties when comparing clinical trials. In addition, the relationship between different outcome measures is poorly understood. The aim of this study was to compare anatomical, hemodynamic, and clinical outcomes with disease-specific quality-of-life tools in patients undergoing treatment for varicose veins.

Hypoxia-inducible factor-1 in arterial disease: a putative therapeutic target.

Hypoxia-inducible factor-1 (HIF-1) is a nuclear transcription factor that is upregulated in hypoxia and co-ordinates the adaptive response to hypoxia by driving the expression of over 100 genes. In facilitating tissues to adapt to hypoxia, HIF-1 may have a role in reducing the cellular damage induced by ischaemia, such as that seen in peripheral arterial disease (PAD), or following acute ischaemic insults such as stroke and myocardial infarction. This therefore raises the possibility of HIF-1 modulation in such contexts to reduce the consequences of ischaemic injury.

A study of patient satisfaction following endothermal ablation for varicose veins.

Objective: To evaluate patient satisfaction following endothermal ablation for varicose veins (VVs).

Methods: A 12-question survey was sent to consecutive patients treated with endothermal ablation--questions related to preprocedure symptoms, recurrence, further treatments, and patient satisfaction.

Results: Questionnaires sent a median 12 (range 6-22) months postintervention were returned by 177 (60.

Pain following 980-nm endovenous laser ablation and segmental radiofrequency ablation for varicose veins: a prospective observational study.

Objectives: The aim of this study was to evaluate postoperative pain following endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) and identify risk factors for increased pain.

Methods: Patients undergoing either segmental RFA (VNUS Closure Fast, VNUS Medical Technologies, San Jose, California) or EVLA (980 nm) for varicose veins completed a preoperative disease-specific quality-of-life questionnaire (Aberdeen Varicose Vein Questionnaire [AVVQ]) and a diary card recording postoperative pain, return to normal activities, and return to work. Median 3- and 10-day pain scores were calculated.

Peripheral arterial disease.

Peripheral arterial disease is commonly caused by atherosclerosis, and symptoms depend on the location and size of the affected artery, metabolic demands on the tissue, and the presence or absence of a collateral circulation. This article reviews the current evidence for the diagnosis and management of peripheral arterial disease.