Speakers' corner: Selected original research abstracts - supraaortic and venouspublished_or_final_versio

Chan, YC

Cheng, SWK

Cheung, GCY

Law, Y

Ting, ACW

Wong, ACC

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TitleEarly single-centre comparative results on non-thermal ablationof symptomatic incompetent great saphenous veins (GSV):cyanoacrylate glue (VenaSeal) versus mechanicochemicalablation (ClariVein)Author(s) Law, Y; Chan, YC; Cheung, GCY; Ting, ACW; Wong, ACC;Cheng, SWKCitation The 2016 Leipzig Interventional Course (LINC), Leipzig,Germany, 26-29 January 2016Issued Date 2016URL http://hdl.handle.net/10722/223286Rights This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Early Single-centre Comparative Results on Non-thermal Ablation of Symptomatic Incompetent Great Saphenous Veins (GSV):  Cyanoacrylate Glue (VenaSeal)  versus  Mechanicochemical ablation (ClariVein)  羅旭  Yuk LAW 香港大學外科學系血管外科  Division of Vascular & Endovascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.  Disclosure  Speaker name: ...............Yuk LAW................................................................ I have the following potential conflicts of interest to report: • Trip sponsorship by IntegMed Ltd   I do not have any potential conflict of interest • Consulting •  Employment in industry •  Stockholder of a healthcare company •  Owner of a healthcare company •  Other(s)   Endovenous Varicose vein treatment are minimally invasive and office based •Thermal energy (+ tumescence anaethesia) •Radiofrequency ablation •Laser •steam •Sclerotherapy •Non thermal ablation •Mechanical and sclerosant (ClariVein) •Cyanoacylate (Venaseal) 静脉腔内静脉曲张治疗 After successful cannulation of the GSV, a guidewire is passed under ultrasound guidance. In the meantime, the cyanoacylate is being drawn up and prepared. Cyanoacrylate Glue (VenaSeal) Mechanicochemical ablation (ClariVein) Completion duplex: successful obliteration of great saphenous vein Completion duplex: absence of thrombus or clots in deep femoral vein Methods • Single center prospective, non randomized comparative study for evaluation of safety and efficacy of VenaSeal v.s. Clarivein • Primary outcomes: – Complications – Clinical recurrence of varicosity and re-intervention – Radiological duplex ultrasound GSV obliteration rate: 4 days, 1 week, 1 month, 3 months, 6 months Patients’ characteristics VenaSeal (n=22) ClariVein (n=24) P value Median age 62 (range 39-80) 60.5 (range 44-76) NS* Male: Female 6:16 8:16 NS^ Co-morbidities - DM - HT - Cardiac  - Renal - COPD  2/22 9/22 6/22 1/22 0/22  0/24 4/24 2/24 0/24 0/24  NS^ NS^ NS^ NS^ NS^ Sides - Unilateral - Bilateral  1/22 21/22  18/24 6/24  <0.001^ VenaSeal group: 43 legs in 22 patients ClariVein group: 30 legs in 18 patients  *Student t test, ^chi square test Leg varicose vein characteristics VenaSeal (n=43) ClariVein (n=30) P value CEAP clinical classification - C3 - C4a - C4b - C5 - C6  28 12 1 1 1  15 9 3 0 3   NS^ Mean diameter of GSV (mm) 7.2 (range 3.9-11.4) 6.5 (range 5.0-10.0) NS* Mean treatment length of GSV (cm) 28.4 (range 20-33) 32.8 (range 25-38) 0.001* *Student t test, ^chi square test Operative outcomes VenaSeal (n=43) ClariVein (n=30) P value Mean operative time (minutes) 64.6 (range 28-99) 72.0 (range 25-125) NS* Primary success 43/43 (100%) 29/30 (96.7%) NS^ Access - Percutaneous - Open  43/43 (100%) 0/43  27/30 (90%) 3/30  NS^ *Student t test, ^chi square test One procedure failure for ClariVein group due to very tortuous GSV; and hence excluded from subsequent analysis Post-operative complications VenaSeal (n=43) ClariVein (n=29) Deep Vein thrombosis 0 0 NS^ Thrombus extension to deep vein 0 3 NS^ Parenthesis 1 0 NS^ Weakness 0 0 NS^ Wound infection 1 0 NS^ Cellulitis 0 1 NS^ Symptomatic thrombophlebitis 0 2 NS^ ^chi square test Clinical outcomes • VenaSeal group: median follow up period 9 months (range 5-12) • ClariVein group: median follow up period 9.5 months (range 1-15) • No clinical recurrence or secondary intervention  ClariVein: Hazard ratio 1.40,  95% CI 0.31-6.28, p=0.661 ClariVein VenaSeal Predictors of recanalization Hazard ratio 95% CI P value ClariVein 1.40 0.31- 6.28 0.661 Mean diameter >= 8mm 3.10 0.69- 13.89 0.139 Mean treatment length <20cm 3.05 0.53- 17.62 0.212 Diameter <8mm >=8mm Conclusion • Both treatment modalities were safe with comparable clinical and radiological outcomes • Trend towards more recanalization in GSV with larger diameter Early Single-centre Comparative Results on Non-thermal Ablation of Symptomatic Incompetent Great Saphenous Veins (GSV):  Cyanoacrylate Glue (VenaSeal)  versus  Mechanicochemical ablation (ClariVein)  羅旭  Yuk LAW 香港大學外科學系血管外科  Division of Vascular & Endovascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.  

Early single-centre comparative results on non-thermal ablation of symptomatic incompetent great saphenous veins (GSV): cyanoacrylate glue (VenaSeal) versus mechanicochemical ablation (ClariVein)

Early single-centre comparative results on non-thermal ablation of symptomatic incompetent great saphenous veins (GSV): cyanoacrylate glue (VenaSeal) versus mechanicochemical ablation (ClariVein)

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