Introduction. Chronic venous insufficiency is one of the most common medical conditions among highly developed societies. The majority of patients (70%) suffer from saphenous veins incompetency. The study presents results of a 3-month follow-up of application of venous mechanochemical ablation system with the FlebogrifTM catheter. Material and methods. The study was conducted on 200 patients, including 170 women and 30 men treated with ablation with FlebogrifTM to treat varicose veins. All patients were qualified based on the ultrasound in a standing position confirming incompetence of the great saphenous vein or small saphenous vein. The vein was punctured under ultrasound guidance in the distal part of the incompetent segment. The area of vascular access was anesthetized with 0.5 mL of 1% lignocaine. The compression therapy in the form of the first grade medical elastic stocking was used after the surgery. Results. The initial technical success of the surgery was achieved in all the patients. During the 3-month follow-up, recanalization occurred in 8 cases, in 5 patients great saphenous vein and in 3 small saphenous vein recanalised. Based on the recommendations of the European Consensus Meeting on Foam Sclerotherapy, 7 cases were defined as complete recanalization and 1 as partial. The analysis of numerical data obtained with Venous Clinical Severity Score and Clinics Ethiology Anatomy Pathophysiology Classification showed a statistically significant decrease in the severity of clinical symptoms compared to ones before the surgery and between particular days of the observation during the 3-month follow-up. Conclusions. The procedure is highly effective reaching 96% at 3 months of follow-up, provides good cosmetic effect and the low rate of complications. Minimal invasiveness of mechanochemical ablation with Flebogrif™ may improve the quality of life during the postoperative period. A long-term observation is recommended to achieve a full-value assessment of this novel method. Introduction. Chronic venous insufficiency is one of the most common medical conditions among highly developed societies. The majority of patients (70%) suffer from saphenous veins incompetency. The study presents results of a 3-month follow-up of application of venous mechanochemical ablation system with the FlebogrifTM catheter. Material and methods. The study was conducted on 200 patients, including 170 women and 30 men treated with ablation with FlebogrifTM to treat varicose veins. All patients were qualified based on the ultrasound in a standing position confirming incompetence of the great saphenous vein or small saphenous vein. The vein was punctured under ultrasound guidance in the distal part of the incompetent segment. The area of vascular access was anesthetized with 0.5 mL of 1% lignocaine. The compression therapy in the form of the first grade medical elastic stocking was used after the surgery. Results. The initial technical success of the surgery was achieved in all the patients. During the 3-month follow-up, recanalization occurred in 8 cases, in 5 patients great saphenous vein and in 3 small saphenous vein recanalised. Based on the recommendations of the European Consensus Meeting on Foam Sclerotherapy, 7 cases were defined as complete recanalization and 1 as partial. The analysis of numerical data obtained with Venous Clinical Severity Score and Clinics Ethiology Anatomy Pathophysiology Classification showed a statistically significant decrease in the severity of clinical symptoms compared to ones before the surgery and between particular days of the observation during the 3-month follow-up. Conclusions. The procedure is highly effective reaching 96% at 3 months of follow-up, provides good cosmetic effect and the low rate of complications. Minimal invasiveness of mechanochemical ablation with Flebogrif™ may improve the quality of life during the postoperative period. A long-term observation is recommended to achieve a full-value assessment of this novel method.
In patients with atherosclerotic stenosis of the extracranial segment of internal carotid artery, surgical intervention is an effective method to prevent cerebral ischemic stroke. However, this surgical procedure may cause vascular brain...
We describe a novel surgical technique to facilitate the second-stage elevation of the basilic or brachial vein in patients with first-stage brachial-basilic or autogenous brachial-brachial arteriovenous fistula by axial splitting of the medial antebrachial cutaneous nerve (MABCN). Filaments of the MABCN typically traverse the anterior aspect of the basilic and brachial veins. The second-stage elevation/shelf superficialization of the basilic or brachial vein, so as not to cause an injury to the MABCN, requires division of these veins with transposition over the nerve branches and subsequent reanastomosis. Our method of axial splitting of the MABCN enables elevation and shelf superficialization of the basilic or brachial vein without the division and reanastomosis of the vein. Twenty-eight patients underwent this simplified elevation. The nerve perineurium was incised longitudinally, nerve fibers were divided intrafascicularly, and cutaneous nerve branches were retracted aside. The vein was elevated between the divided nerves. On discharge and at 1-month follow-up, only one patient complained of localized patch hypoesthesia as reported in a simplified neurologic assessment questionnaire and neurologic examination.