A systematic review and meta-analysis on the role of varicosity treatment in the context of truncal vein ablation

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Title: A systematic review and meta-analysis on the role of varicosity treatment in the context of truncal vein ablation
Authors: Lane, TRA
Onida, S
Gohel, MS
Franklin, IJ
Davies, AH
Item Type: Journal Article
Abstract: Background: With the advent of endovenous truncal ablation under local anaesthetic for the treatment of varicose veins, the fate of varicosed tributaries has become controversial, with centres offering different timings of treatment, if offered at all. This study aims to review the literature assessing delayed and simultaneous varicosity treatment during truncal ablation. Methods: Randomised trials and cohort studies concerning varicosity treatment timing were identified through a systematic literature search. Requirements for further treatment, quality of life and rate of venous thrombotic events were assessed for meta-analysis. Results: Four studies were identified assessing need for further varicosity procedure, with no significant difference seen between simultaneous or delayed treatment (p ¼ 0.339). Two studies assessed quality of life, with simultaneous treatment providing significantly improved outcomes at six weeks (p ¼ 0.029) but not at 12 weeks (p ¼ 0.283). Studies examining venous thrombotic events showed no difference in venous thromboembolism rate between simultaneous or delayed treatment approaches (p ¼ 0.078). Conclusion: The evidence base regarding timing of varicosity treatment is sparse; however, it does show that simultaneous treatment of varicosities leads to early gains in quality of life, with a non-significant trend for fewer further procedures but more venous thrombotic events.
Issue Date: 18-Aug-2014
Date of Acceptance: 1-Aug-2014
URI: http://hdl.handle.net/10044/1/49731
DOI: https://dx.doi.org/10.1177/0268355514548473
ISSN: 0268-3555
Publisher: SAGE Publications
Start Page: 516
End Page: 524
Journal / Book Title: Phlebology
Volume: 30
Issue: 8
Copyright Statement: © 2014 The Author(s). The final, definitive version of this paper has been published in Phlebology, Vol 30, Issue 8, pp. 516 - 524 by Sage Publications Ltd. All rights reserved. It is available at: https://dx.doi.org/10.1177/0268355514548473
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Varicose veins
truncal ablation
endovenous
phlebectomy
avulsion
varicosity
ENDOVENOUS LASER-ABLATION
GREAT SAPHENOUS-VEIN
RANDOMIZED CLINICAL-TRIAL
FOAM SCLEROTHERAPY
RADIOFREQUENCY ABLATION
VENOUS INSUFFICIENCY
PATIENT SATISFACTION
SINGLE-CENTER
PHLEBECTOMY
CONCOMITANT
Catheter Ablation
Female
Humans
Male
Quality of Life
Randomized Controlled Trials as Topic
Varicose Veins
Venous Thromboembolism
Venous Thrombosis
1102 Cardiovascular Medicine And Haematology
Cardiovascular System & Hematology
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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