Perforan Ven Yetmezliğinde; Küçük Kesi ile Ligasyon, Lazer Ablasyon ve Siyanoakrilat ile Embolizasyon Tekniklerinin Karşılaştırılması

Amaç: Bu çalışma inkompetan perforan ven tedavisinin üç ana yönteminin erken ve orta dönem sonuçlarını karşı- laştırmak amacı ile planlanmıştır. Yöntemler: Ocak 2012 ve Ocak 2015 arasında sadece inkompetan perforan ven cerrahisi için operasyona alınmış ardışık 84 hastada uygulanmış 174 işlemin verileri retrospektif olarak analiz edilmiştir. Hastalar uygulanan yönteme göre 3 gruba ayrıldı; küçük kesi ile ligasyon 40 (%47,6), lazer ile endovenöz ablasyon 22 (%26,2), siyanoakrilat ile embolizasyon 22 (%26,2). Preoperatif, operatif ve erken dönem takip verileri kayıt edildi. Hastalar polikliniğe çağrılarak ultrason ile nüks açısından tekrar değerlendirildi. Bulgular: Operasyon süresi, küçük kesi ile ligasyon grubunda daha uzundu (p

A Comparison Of Mini-incisional Ligation, Laser Ablation And Cyanoacrylate Embolization For Incompetent Perforating Vein Closure

Objective: Our aim was to compare the short- and the midterm results of three main methods of incompetent perforating vein treatment. Methods: Data of 174 procedures performed between January 2012 and January 2015, in a 84 consecutive patients with incompetent perforating veins were retrospectively analyzed. Patients were divided into 3 groups according to surgical technique: mini-incisional ligation 40 (47.6%), 22 (26.2%) endovenous laser ablation and 22 (26.2%) cyanoacrylate embolization. Preoperative, operative and early follow up data was recorded. All patients were called to assess by ultrasonography for recurrence. Results: Operation time was significantly longer in the mini-incisional ligation group (p<0.001). Cyanoacrylate group showed significantly lower hospital stay (p<0.001), duration of analgesia (p<0.001) and disability (p<0.001). Recurrence was not found in the ligation group (p<0.001), endovenous laser group showed significantly higher recurrence than the cyanoacylate group (p<0.001). Cosmetic problems (hyperpigmentation or scar tissue) were significantly higher in the mini-incisional ligation group (p =0.003). Paresthesia was detected after endovenous laser (p=0.001). Conclusion: Although ligation has still lowest rate of recurrence after incompetent perforating vein surgery, it is being replaced by the endovascular procedure due to cosmetic problems. Cyanoacrylate embolization seems to be a promising alternative for incompetent perforating veins treatment due to higher recurrence and complication rate after endovenous laser ablation.

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