ABSTRACT
Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats.
Subject(s)
Animals , Female , Male , Fibrinolysis , Fibrosis , Goats , Laser Coagulation , Methods , Microwaves , Therapeutic Uses , Necrosis , Platelet Activation , Postoperative Complications , Venous Insufficiency , General SurgeryABSTRACT
Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical therapeutic effects of oral administration and external application of Chinese drugs combined with micro-invasive surgery for the treatment of varicose ulcers in the lower extremities (ecthyma).</p><p><b>METHODS</b>A total of 152 patients (163 limbs) suffering from varicose ulcers on the lower limbs were assigned to two groups according to the patients' willingness. The 102 cases (109 limbs) in the treatment group underwent the method of endovenous microwave closure of communicating veins combined with oral administration and external application of Chinese drugs before and after the operation. The 50 cases (54 limbs) in the control group, were treated with oral administration and external application of Chinese drugs only. Clinical manifestations, including the condition of ulcer healing, the improvement conditions of alogotrophy, edema and other symptoms, were observed before and after 3 months of treatment. The clinical healing rate, the ulcer healing time, and the ulcer recurrence rate, were compared between the two groups. All the patients were followed-up 3 months after treatment.</p><p><b>RESULTS</b>The follow-up was carried out for 3 to 42 months (mean 30.5 months). In the treatment group, 99 patients (106 limbs) were clinically cured, and the clinical healing rate was 97.06%; the ulcer healing time was 9-101 days (average 31.25+/-8.28 days) and 3 cases (5 limbs) had recurrence; the ulcer recurrence rate was 5.81%. In the control group, 40 patients (43 limbs) were clinically cured, with a clinical healing rate of 80.00%; the ulcer healing time was 10-152 days (average 50.60+/-12.31 day) and 5 cases (7 limbs) recurred, with the ulcer recurrence rate being 20.59%. The effects in the treatment group were obviously better than those in the control group (P<0.01 or P<0.05).</p><p><b>CONCLUSION</b>The oral administration and external application of Chinese drugs combined with micro-invasive surgery for the treatment of varicose ulcers in the lower extremities has a significant curative effect, with a higher clinical healing rate, shorter ulcer healing time and lower ulcer recurrence rate than either treatment alone.</p>