Práticas de terapia compressiva pós-ablação da veia safena magna: um estudo entre os membros da Sociedade Brasileira de Angiologia e Cirurgia Vascular
Post-saphenous vein ablation compression therapy practices: a study among members of the Brazilian society of angiology and vascular surgery
Fabricio Duarte; Flavia Del Castanhel; Marcondes Antônio de Medeiros Figueiredo; Getúlio Rodrigues de Oliveira Filho
Resumo
Palavras-chave
Abstract
Background: Despite considerable study, there is still no consensus defining the ideal compression regimen after ablation of the great saphenous vein with radio frequency or endolaser.
Objective: To identify the Brazilian Society of Angiology and Vascular Surgery members’ current compression therapy practices after ablation of the great saphenous vein
Methods: A multiple-choice electronic questionnaire on post-endovenous ablation compression was developed and made available on-line to Brazilian vascular surgeons for 60 days.
Results: A total of 430 responses were received, 362 (84.2%) of which were considered valid. Laser ablation was the predominant technique (73.5%) and the majority
of procedures were conducted in hospitals or day hospitals. Ninety-four percent of the surgeons treated associated varicose veins in the same procedure, for which phlebectomy was the technique most employed. After ablation of the great saphenous vein, 99% of the surgeons applied compression immediately; 34.3% used 35 mmHg compression stockings, 26% preferred crepe bandages, and 12.4% opted for 20-30 mmHg compression stockings, with an average duration of 2.79 (±2 days). After this period, 88.4% used additional compression, with 20-30 mmHg compression stockings (80.9%) and an average duration of 39.3 (±24.0 days)
Conclusions: Compression therapy is widely employed after thermal ablation of the great saphenous vein. Practice immediately after ablation was divergent, but after the initial phase, the majority of surgeons prescribed additional compression, predominantly using 20-30 mmHg stockings.
Keywords
References
1 Castro e Silva M, Cabral ALS, Barros N Jr, Castro AA, Santos MERC. Diagnóstico e tratamento da doença venosa crônica. J Vasc Bras. 2005;4(Supl 2):S185-94.
2 Barros N Jr, Perez MDCJ, Amorim JE, Miranda F Jr. Gestação e varizes dos membros inferiores: prevalência e fatores de risco. J Vasc Bras. 2010;9:29-35.
3 Scuderi A, Raskin B, Al Assal F, et al. The incidence of venous disease in Brazil based on the CEAP classification. Int Angiol. 2002;21(4):316-21. PMid:12518109.
4 Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg. 2011;98(8):1079-87.
5 Carradice D, Mekako AI, Mazari FA, Samuel N, Hatfield J, Chetter IC. Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg. 2011;98(4):501-10.
6 Shadid N, Ceulen R, Nelemans P, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg. 2012;99(8):1062-70.
7 Marsden G, Perry M, Kelley K, Davies AH, Guideline Development Group. Diagnosis and management of varicose veins in the legs: summary of NICE guidance. BMJ. 2013;347:f4279.
8 De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor’s Choice - European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limb. Eur J Vasc Endovasc Surg. 2022;63(2):184-267.
9 Kikuchi R, Nhuch C, Drummond DAB, et al. Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery. J Vasc Bras. 2023;22:e20230064.
10 Lurie F, Lal BK, Antignani PL, et al. Compression therapy after invasive treatment of superficial veins of the lower extremities: clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology. J Vasc Surg Venous Lymphat Disord. 2019;7(1):17-28.
11 Al Shakarchi J, Wall M, Newman J, et al. The role of compression after endovenous ablation of varicose veins. J Vasc Surg Venous Lymphat Disord. 2018;6(4):546-50.
12 Ayo D, Blumberg S, Rockman C, et al. Compression versus no compression after endovenous ablation of the great saphenous vein: a randomized controlled trial. Ann Vasc Surg. 2017;38:72-7.
13 Committee on Publication Ethics. Guidelines on good publication practice: the COPE report. United Kingdom: COPE; 1999. p. 43-7.
14 Rastel D, Perrin M, Guidicelli H. Compressive therapy after varicose vein surgery: results of a French national inquiry. J Mal Vasc. 2004;29(1):27-34.
15 El-Sheikha J, Nandhra S, Carradice D, et al. Compression regimes after endovenous ablation for superficial venous insufficiency survey of members of the Vascular Society of Great Britain and Ireland. Phlebology. 2016;31(1):16-22.
16 Bakker NA, Schieven LW, Bruins RM, van den Berg M, Hissink RJ. Compression stockings after endovenous laser ablation of the great saphenous veins: a prospective randomized controlled trial. Eur J Vasc Endovasc Surg. 2013;46(5):588-92.
17 Mii S, Guntani A, Yoshiga R, Matsumoto T, Kawakubo E, Okadome J. Optimal Duration of compression stocking therapy after endovenous laser ablation using a 1470-nm diode dual-ring radial laser fiber for great saphenous vein insufficiency. Ann Vasc Dis. 2021;14(2):122-31.
18 Biswas S, Clark A, Shields DA. Randomised clinical trial of the duration of compression therapy after varicose vein surgery. Eur J Vasc Endovasc Surg. 2007;33(5):631-7.
19 Partsch B, Partsch H. Which pressure do we need to compress the great saphenous vein on the thigh? Dermatol Surg. 2008;34(12):1726-8. PMid:19076900.
20 Cavezzi A, Mosti G, Colucci R, Quinzi V, Bastiani L, Urso SU. Compression with 23 mmHg or 35 mmHg stockings after saphenous catheter foam sclerotherapy and phlebectomy of varicose veins: a randomized controlled study. Phlebology. 2019;34(2):98-106.
21 Krasznai AG, Sigterman TA, Troquay S, et al. A randomised controlled trial comparing compression therapy after radiofrequency ablation for primary great saphenous vein incompetence. Phlebology. 2015;31(2):118-24.
22 Onwudike M, Abbas K, Thompson P, McElvenny DM. Role of compression after radiofrequency ablation of varicose veins: a randomised controlled trial. Eur J Vasc Endovasc Surg. 2020;60(1):108-17.
23 Hu H, Wang J, Wu Z, Liu Y, Ma Y, Zhao J. No benefit of wearing compression stockings after endovenous thermal ablation of varicose veins: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2022;63(1):103-11.
24 Zhang D, Shi C, Zhang Y, et al. Compression versus no compression after endovenous radiofrequency ablation: a meta-analysis of randomized controlled trials. Phlebology. 2022;37(8):555-63.
25 Elderman JH, Krasznai AG, Voogd AC, Hulsewé KW, Sikkink CJ. Role of compression stockings after endovenous laser therapy for primary varicosis. J Vasc Surg Venous Lymphat Disord. 2014;2(3):289-96.
26 Bootun R, Belramman A, Bolton-Saghdaoui L, Lane TRA, Riga C, Davies AH. Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial). Ann Surg. 2021;273(2):232-9.
27 Coelho F, Araújo WJB, Belczak S, et al. Influence of compression therapy following varicose vein surgery: a prospective randomized study. J Vasc Bras. 2023;22:e20220052.
Submitted date:
12/25/2023
Accepted date:
03/23/2024
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email