VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.409 |
Resumo: | Introduction: Chronic venous disease is a prevalent condition that worsens with age and is associated with poor quality of life.The treatment of varicose veins (VV) has multiple alternatives, and different practices across Europe.The aim of this article is to analyze the treatment of very elderly patients with severe forms of chronic venous disease using the VenaSeal technique. Method, Material and Results: Report of 5 very old patients with severe venous insufficiency treated with Vena- Seal in 2021. Clinical case 1: A 86-year-old woman, with untreated bilateral varicose veins and recurrent ulcers, was observed in consultation, complaining of severe pain in left leg with an doppler ultrasound (DUS) showing bilateral great saphenous vein (GSV) insufficiency.An outpatient basis treatment of the left great saphenous vein with VenaSeal associated with phlebectomies was performed in the left side. After 6 months of follow-up, she is asymptomatic with small areas of repermeabilization of the proximal trunk of GSV. Clinical case 2: A 85-year-old man was observed in consultation describing two episodes of varicorrhagia in his right leg and and DUS with bilateral great saphenous vein insufficiency.An outpatient basis treatment of the right great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After a 3-month follow-up, the patient is asymptomatic with the imaging control showing occlusion of the trunk of the great saphenous vein. Clinical case 3: A 97-year-old woman was observed in consultation complaining of severe pain in left leg associated with an ulcer with severe interference with her quality of life and a DUS with bilateral great saphenous vein insufficiency. An outpatient basis treatment of the left great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After a 2-month follow-up, the patient is asymptomatic with a healed ulcer, with the DUS control showing occlusion of the great saphenous trunk. Clinical case 4: A 95-year-old woman was observed in consultation describing bilateral severe pain and ulcers in both legs and DUS with bilateral great saphenous vein insufficiency.An outpatient basis treatment of bilateral great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After 1-month follow-up, she is asymptomatic with healed ulcers and has occlusion of the right GSV ́s trunk and areas of repermeabilization of left GSV ́s trunk. Clinical case 5: An 84-year-old woman was observed in consultation with severe pain and severe pruritus of the left leg and a DUS with left GSV insufficiency.An outpatient basis treatment of the left GSV with VenaSeal associated with phlebectomies was performed.After 1 month of follow-up, the patient is asymptomatic with occlusion of the proximal left GSV ́s trunk. Discussion/Conclusion: Treatment with Venaseal is not considered in the 2015 Guidelines of the ESVS, however the VeClose Study compared VenaSeal with radiofrequency ablation and reported equivalent improvement in symptoms scores and GSV occlusion.VenaSeal treatment doesn ́t require use of elastic compression after surgery and allows return to routine activity immediately, so it may be a good therapeutic option in this age group of patients with high clinical risk. In our experience, VenaSeal resulted in complete resolution of the symptoms and ulcers in the short term. However, a complete occlusion of GSV was not observed in all cases, so new studies and protocols doses can be necessary. |
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VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTSVENASEAL: UMA BOA SOLUÇÃO NO TRATAMENTO DA INSUFICIÊNCIA VENOSA SUPERFICIAL GRAVE EM DOENTES MUITO IDOSOSvenasealelderyVenous cronic diseaseVaricose veinsVenasealIdososInsuficiência venosa crónicaVarizesIntroduction: Chronic venous disease is a prevalent condition that worsens with age and is associated with poor quality of life.The treatment of varicose veins (VV) has multiple alternatives, and different practices across Europe.The aim of this article is to analyze the treatment of very elderly patients with severe forms of chronic venous disease using the VenaSeal technique. Method, Material and Results: Report of 5 very old patients with severe venous insufficiency treated with Vena- Seal in 2021. Clinical case 1: A 86-year-old woman, with untreated bilateral varicose veins and recurrent ulcers, was observed in consultation, complaining of severe pain in left leg with an doppler ultrasound (DUS) showing bilateral great saphenous vein (GSV) insufficiency.An outpatient basis treatment of the left great saphenous vein with VenaSeal associated with phlebectomies was performed in the left side. After 6 months of follow-up, she is asymptomatic with small areas of repermeabilization of the proximal trunk of GSV. Clinical case 2: A 85-year-old man was observed in consultation describing two episodes of varicorrhagia in his right leg and and DUS with bilateral great saphenous vein insufficiency.An outpatient basis treatment of the right great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After a 3-month follow-up, the patient is asymptomatic with the imaging control showing occlusion of the trunk of the great saphenous vein. Clinical case 3: A 97-year-old woman was observed in consultation complaining of severe pain in left leg associated with an ulcer with severe interference with her quality of life and a DUS with bilateral great saphenous vein insufficiency. An outpatient basis treatment of the left great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After a 2-month follow-up, the patient is asymptomatic with a healed ulcer, with the DUS control showing occlusion of the great saphenous trunk. Clinical case 4: A 95-year-old woman was observed in consultation describing bilateral severe pain and ulcers in both legs and DUS with bilateral great saphenous vein insufficiency.An outpatient basis treatment of bilateral great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After 1-month follow-up, she is asymptomatic with healed ulcers and has occlusion of the right GSV ́s trunk and areas of repermeabilization of left GSV ́s trunk. Clinical case 5: An 84-year-old woman was observed in consultation with severe pain and severe pruritus of the left leg and a DUS with left GSV insufficiency.An outpatient basis treatment of the left GSV with VenaSeal associated with phlebectomies was performed.After 1 month of follow-up, the patient is asymptomatic with occlusion of the proximal left GSV ́s trunk. Discussion/Conclusion: Treatment with Venaseal is not considered in the 2015 Guidelines of the ESVS, however the VeClose Study compared VenaSeal with radiofrequency ablation and reported equivalent improvement in symptoms scores and GSV occlusion.VenaSeal treatment doesn ́t require use of elastic compression after surgery and allows return to routine activity immediately, so it may be a good therapeutic option in this age group of patients with high clinical risk. In our experience, VenaSeal resulted in complete resolution of the symptoms and ulcers in the short term. However, a complete occlusion of GSV was not observed in all cases, so new studies and protocols doses can be necessary.Introdução: A doença venosa crónica é uma condição prevalente que piora com a idade e está associada a reduzida qualidade de vida.O tratamento das varizes dos membros inferiores tem várias alternativas e diferentes práticas em toda a Europa.O objetivo deste artigo é analisar o tratamento de pacientes muito idosos com formas graves de doença venosa crónica pela técnica de VenaSeal. Método, Material e Resultados: Descrição de 5 doentes muito idosos com insuficiência venosa grave tratados com VenaSeal em 2021. Caso clínico 1: Uma mulher de 86 anos com varizes bilaterais não tratadas e úlceras recorrentes de longa evolução, foi observada em consulta, referindo dores incapacitantes na perna esquerda observando-se no ecodoppler insufi- ciência da veia grande safena bilateralmente.Foi realizado tratamento ambulatório da veia grande safena esquerda com VenaSeal associado a flebectomias do membro inferior esquerdo. Com 6 meses de seguimento, encontra-se assintomática, observando-se no ecodoppler de controlo realizado pequenas áreas de repermeabilização do tronco proximal da veia grande safena. Caso clínico 2: Homem de 85 anos foi observado em consulta referindo dois episódios de varicorragia exuberantes na perna direita, observando-se no ecodoppler insuficiência da veia grande safena bilateralmente.Foi realizado tratamento ambulatório de veia grande safena com VenaSeal associado a ecoesclerose de varizes. Com 3 meses de seguimento encontra-se assintomático, observando-se no ecodoppler de controlo imagem de oclusão do tronco da veia grande safena. Caso clínico 3: Mulher de 97 anos observada em consulta referindo dor intensa na perna esquerda associada a úlcera com forte interferência com a sua qualidade de vida, observando-se no ecodoppler insuficiência da veia grande safena bilateralmenteFoi realizado tratamento ambulatório da veia grande safena esquerda com VenaSeal associado a ecoesclerose de varizes. Com 2 meses de seguimento encontra-se assintomática com úlcera cicatrizada, observando-se no ecodoppler de controlo oclusão do tronco da veia grande safena. Caso clínico 4: Mulher de 95 anos observada em consulta referindo dor intensa associada a úlceras em ambas as pernas, observando-se no ecodoppler insuficiência da veia grande safena bilateralmente.Foi realizado tratamento ambulatório de veia grande safena bilateralmente com VenaSeal associado a ecoescle- rose de varizes. Com 1 mês de seguimento encontra-se assintomática e com úlceras cicatrizadas, observando-se no ecodoppler de controlo oclusão do tronco da veia grande safena direita e áreas de repermeabilização do tronco da veia grande safena esquerda. Caso clínico 5: Mulher de 84 anos de idade observada em consulta referindo dor e prurido intenso na perna esquerda, observando-se no ecodoppler insuficiência da veia grande safena esquerda.Foi realizado tratamento ambulatório da veia grande safena esquerda com VenaSeal associado a flebectomias.Com 1 mês de seguimento, encontra-se assintomática observando-se no ecodoppler de controlo oclusão do tronco da veia grande safena esquerda. Discussão / Conclusão: O tratamento com Venoseal não é considerado nos guidelines da ESVS de 2015, no entanto, o Estudo VeClose comparou o tratamento com VenaSeal com o tratamento por radiofrequência e mostrou resultados equivalente nos scores sintomáticos e na taxa se oclusão das veias safenas .O tratamento com VenaSeal não requer o uso de compressão elástica e permite o retorno imediato às atividades de rotina, podendo ser uma boa opção terapêutica em pacientes desta faixa etária que possuem um alto risco clínico. Na nossa experiência, o VenaSeal resultou na resolução completa dos sintomas e úlcera no curto prazo. Porém, ao não ser observada uma oclusão completa da veia grande safena em todos os casos, são necessários novos estudos e novos protocolos de dosagem são necessários.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2021-12-24T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.409oai:ojs.acvjournal.com:article/409Angiologia e Cirurgia Vascular; Vol. 17 No. 3 (2021): September; 246-251Angiologia e Cirurgia Vascular; Vol. 17 N.º 3 (2021): Setembro; 246-2512183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/409https://doi.org/10.48750/acv.409http://acvjournal.com/index.php/acv/article/view/409/259Copyright (c) 2021 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessMachado, MartaMachado, MiguelMatos, ArlindoMachado, Rui2022-05-23T15:10:13Zoai:ojs.acvjournal.com:article/409Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:45.014563Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS VENASEAL: UMA BOA SOLUÇÃO NO TRATAMENTO DA INSUFICIÊNCIA VENOSA SUPERFICIAL GRAVE EM DOENTES MUITO IDOSOS |
title |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS |
spellingShingle |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS Machado, Marta venaseal eldery Venous cronic disease Varicose veins Venaseal Idosos Insuficiência venosa crónica Varizes |
title_short |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS |
title_full |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS |
title_fullStr |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS |
title_full_unstemmed |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS |
title_sort |
VENASEAL: A GOOD SOLUTION IN THE TREATMENT OF SEVERE SUPERFICIAL VENOUS INSUFFICIENCY IN VERY ELDERLY PATIENTS |
author |
Machado, Marta |
author_facet |
Machado, Marta Machado, Miguel Matos, Arlindo Machado, Rui |
author_role |
author |
author2 |
Machado, Miguel Matos, Arlindo Machado, Rui |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Machado, Marta Machado, Miguel Matos, Arlindo Machado, Rui |
dc.subject.por.fl_str_mv |
venaseal eldery Venous cronic disease Varicose veins Venaseal Idosos Insuficiência venosa crónica Varizes |
topic |
venaseal eldery Venous cronic disease Varicose veins Venaseal Idosos Insuficiência venosa crónica Varizes |
description |
Introduction: Chronic venous disease is a prevalent condition that worsens with age and is associated with poor quality of life.The treatment of varicose veins (VV) has multiple alternatives, and different practices across Europe.The aim of this article is to analyze the treatment of very elderly patients with severe forms of chronic venous disease using the VenaSeal technique. Method, Material and Results: Report of 5 very old patients with severe venous insufficiency treated with Vena- Seal in 2021. Clinical case 1: A 86-year-old woman, with untreated bilateral varicose veins and recurrent ulcers, was observed in consultation, complaining of severe pain in left leg with an doppler ultrasound (DUS) showing bilateral great saphenous vein (GSV) insufficiency.An outpatient basis treatment of the left great saphenous vein with VenaSeal associated with phlebectomies was performed in the left side. After 6 months of follow-up, she is asymptomatic with small areas of repermeabilization of the proximal trunk of GSV. Clinical case 2: A 85-year-old man was observed in consultation describing two episodes of varicorrhagia in his right leg and and DUS with bilateral great saphenous vein insufficiency.An outpatient basis treatment of the right great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After a 3-month follow-up, the patient is asymptomatic with the imaging control showing occlusion of the trunk of the great saphenous vein. Clinical case 3: A 97-year-old woman was observed in consultation complaining of severe pain in left leg associated with an ulcer with severe interference with her quality of life and a DUS with bilateral great saphenous vein insufficiency. An outpatient basis treatment of the left great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After a 2-month follow-up, the patient is asymptomatic with a healed ulcer, with the DUS control showing occlusion of the great saphenous trunk. Clinical case 4: A 95-year-old woman was observed in consultation describing bilateral severe pain and ulcers in both legs and DUS with bilateral great saphenous vein insufficiency.An outpatient basis treatment of bilateral great saphenous vein with VenaSeal associated with varicose veins foam esclerotherapy DUS guided was performed. After 1-month follow-up, she is asymptomatic with healed ulcers and has occlusion of the right GSV ́s trunk and areas of repermeabilization of left GSV ́s trunk. Clinical case 5: An 84-year-old woman was observed in consultation with severe pain and severe pruritus of the left leg and a DUS with left GSV insufficiency.An outpatient basis treatment of the left GSV with VenaSeal associated with phlebectomies was performed.After 1 month of follow-up, the patient is asymptomatic with occlusion of the proximal left GSV ́s trunk. Discussion/Conclusion: Treatment with Venaseal is not considered in the 2015 Guidelines of the ESVS, however the VeClose Study compared VenaSeal with radiofrequency ablation and reported equivalent improvement in symptoms scores and GSV occlusion.VenaSeal treatment doesn ́t require use of elastic compression after surgery and allows return to routine activity immediately, so it may be a good therapeutic option in this age group of patients with high clinical risk. In our experience, VenaSeal resulted in complete resolution of the symptoms and ulcers in the short term. However, a complete occlusion of GSV was not observed in all cases, so new studies and protocols doses can be necessary. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12-24T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.409 oai:ojs.acvjournal.com:article/409 |
url |
https://doi.org/10.48750/acv.409 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/409 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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http://acvjournal.com/index.php/acv/article/view/409 https://doi.org/10.48750/acv.409 http://acvjournal.com/index.php/acv/article/view/409/259 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 17 No. 3 (2021): September; 246-251 Angiologia e Cirurgia Vascular; Vol. 17 N.º 3 (2021): Setembro; 246-251 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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