Métodos físicos utilizados para oclusão de varizes dos membros inferiores

Marcelo Araújo; Fermin de C. Garcia Velasco

doi:10.1590/S1677-54492006000200010

Artigo de Revisão

Métodos físicos utilizados para oclusão de varizes dos membros inferiores

Physical methods used to promote occlusion of varicose veins of the lower limbs

Marcelo Araújo; Fermin de C. Garcia Velasco

http://dx.doi.org/10.1590/S1677-54492006000200010 J Vasc Bras, vol.5, n2, p.139-146, 2006

PDF

Downloads: 2

Resumo

A terapia das varizes dos membros inferiores tem sido realizada classicamente por cirurgia e escleroterapia, sendo a escolha basicamente dependente do seu calibre. Entretanto, a associação de técnicas costuma ser uma necessidade para a obtenção de bons resultados. Os meios físicos surgiram no final da década de 50 e continuaram a progredir com grande diversidade quanto à natureza, princípio físico e efeitos. A complexidade tecnológica é bastante variável. Eletrocoagulação, laser, luz intensa pulsada, crioesclerose endovascular, ultra-som e microondas são meios físicos potencialmente viáveis para esta condição. Entretanto, com algumas exceções, pouco tem sido descrito fora dos centros de pesquisa, e a participação como opção terapêutica ainda necessita de uma melhor definição do papel. O artigo tem como objetivo descrever os métodos físicos empregados ou em estudo para a terapia de varizes.

Palavras-chave

Varizes, laser, ultra-som, microondas, eletrocoagulação, radiofreqüência, terapia, telangiectasias

Abstract

The therapy of varicose veins of the lower limbs has classically been carried out with surgery and sclerotherapy, depending on vessel diameter. However, the association of techniques is frequently necessary to assure a good result. The use of physical procedures to promote occlusion of varicose veins was firstly attempted in the 1950s. There are different physical principles and effects based on different technological levels. Electrocoagulation, laser, intense pulsed light, endovascular cryosclerosis, ultrasound and microwave are physical sources potentially useful for this condition. Unfortunately, these technologies are not wide available outside research centers, with a few exceptions, and their role in clinical practice still needs to be defined. This paper aims to describe the physical procedures currently used or potentially useful for the therapy of varicose veins.

Keywords

Varicose veins, laser, ultrasound, microwave, electrocoagulation, radiofrequency, therapy, telangiectasias

Referências

Hippocrates . 400 BC: On ulcers. The Internet Classics Archive. .

Elsholtz JS. Clysmatica nova: sive, ratio, qua in venam sectam medicamenta immitti possint, ut eodem modo, ac si per os assumta fuissent, operentur: addita etiam omnibus seculis inaudita sanguinis transfusione. 1667.

Pravaz J-C-T. Essai sur le traitement des anéurismes par lês injections de perchlorure de fer. 1857.

Silveira PRM. A escleroterapia hoje. Rev Angiol Cir Vasc.. 1993;2:144-7.

Hejhal L, Firt P, Livora D. Endovascular electrocoagulation of superficial varices of leg. Rozhl Chir.. 1959;38:418-25.

Teruya TH, Ballard JL. New approaches for the treatment of varicose veins. Surg Clin North Am.. 2004;84:1397-417.

Araújo M. Terapia ultra-sônica oclusora percutânea das varizes e telangiectasias dos membros inferiores: ensaio clínico aleatório. .

Werner G, Alexander HA, McPheeters HO. Electrofulguration: new surgical method for varicose veins. Minn Med.. 1964;47:255-7.

Schanno JF. Electrocoagulation: a critical analysis of its use as an adjunct in surgery for varicose veins. Angiology. 1968;19:288-92.

Miyake RK, Miyake H, Duarte FH, Fidelis RJR. Microvarizes e telangiectasias. Angiologia e cirurgia vascular: guia ilustrado. 2003.

Musaev SM. Intravascular electrocoagulation of dilated subcutaneous varicose veins of the lower extremities. Eksp Khir Anesteziol.. 1963;27:36-7.

Politowski M, Zelazny T. Complications and difficulties in electrocoagulation of varices of the lower extremities. Surgery. 1966;59:932-4.

Watts GT. Endovenous diathermy destruction of internal saphenous. Br Med J.. 1972;4.

O'Reilly K. Letter: endovenous diathermy sclerosis as a unit of the armamentarium for the attack on varicose veins. Med J Aust.. 1974;1.

Milleret R, Le Pivert P. Cryosclerosis of the saphenous veins in varicose reflux in the obese and elderly. Phlebologie. 1981;34:601-5.

Le Pivert P. Controlled cryosurgery of varices of the lower extremities: A new therapeutic approach. Apropos of 350 cases. Phlebologie. 1987;40:123-48.

Etienne G, Constantin JM, Hevia M. Cryo-stripping: an advance in the treatment of varicose veins. 3811 operated limbs. Presse Med.. 1995;24:1017-20.

Breuninger H. Cryostripping of the long saphenous vein with a percutaneously guided probe. Dermatol Surg.. 2001;27:545-8.

Ripoll-Sanchez M. Presentación de una técnica: crioesclerosis líquida. Rev Soc Esp Med Estet.. 1995;39:19-24.

Ferreira MV, Seidel AC, Fregadolli LV, Borghesan CE. Aferição da temperatura da glicose utilizada na crioescleroterapia. J Vasc Bras.. 2005;4:155-60.

Einstein A. Zur Quantentheorie der Strahlung. Physiol.. 1917;18:121-8.

Kaplan I, Peled I. The carbon dioxide laser in the treatment of superficial telangiectasias. Br J Plast Surg.. 1975;28:214-5.

Maillet H. O laser: princípios e técnicas de aplicação. 1987.

Haina D, Landthaler M, Braun-Falco O, Waidelich W. Comparison of maximum coagulation depth in human skin for different types of medical lasers. Lasers Surg Med.. 1987;7:355-62.

Fitzpatrick TB. Soleil et peau. J Med Esthet.. 1975;2:33-7.

Navarro L, Min RJ, Bone C. Endovenous laser: a new minimally invasive method of treatment for varicose veins - preliminary observations using an 810 nm diode laser. Dermatol Surg.. 2001;27:117-22.

Proebstle TM, Lehr HA, Kargl A. Endovenous treatment of the greater saphenous vein with 940 nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg.. 2002;35:729-36.

Parente EJ, Rosenblatt M. Endovenous laser treatment to promote venous occlusion. Lasers Surg Med.. 2003;33:115-8.

Muhlbauer W, Nath G, Kreitmair A. Treatment of capillary hemangiomas and nevi flammei with light. Langenbecks Arch Chir. 1976:91-4.

Goldman MP, Eckhouse S. Photothermal sclerosis of leg veins: ESC Medical Systems, LTD Photoderm VL Cooperative Study Group. Dermatol Surg.. 1996;22.

Goldman MP. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatol Surg.. 2000;26:452-6.

Weiss RA, Weiss MA. Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: a 2-year follow-up. Dermatol Surg.. 2002;28:38-42.

Lowe NJ, Grozdev B, Moore D. Microwave delivery system for lower leg telangiectasias. J Cutan Laser Ther.. 2000;2:3-7.

Grémy F, Pagès J-C. Éléments de biophysique. 1966.

Docker MF, Foulkes DJ, Patrick MK. Ultrasound couplants for physiotherapy. Physiotherapy. 1982;68:124-5.

Forrest JO. Ultrasonic scaling: A five-year assessment. Br Dent J.. 1967;122:9-14.

Bihrle R, Foster RS, Sanghvi NT, Donohue JP, Hood PJ. High intensity focused ultrasound for the treatment of benign prostatic hyperplasia: early United States clinical experience. J Urol.. 1994;151:1271-5.

Kelman CD. Phaco-emulsification and aspiration: A new technique of cataract removal. A preliminary report. Am J Ophthalmol.. 1967;64:23-35.

Kelman CD. Phaco-emulsification and aspiration: A report of 500 consecutive cases. Am J Ophthalmol.. 1973;75:764-8.

Bruno G, Amadei F, Abbiati G. Liposculpture with ultrasound: biomedical considerations. Aesthetic Plast Surg. 1998;22:401-3.

Wuchinich D. Ultrasonic surgical aspiration: instrumentation, clinical experience and safety. Plast Reconstr Surg.. 1998;102:281-3.

Belcaro G, Nicolaides AN, Marlinghaus EH. Shock waves in vascular diseases: an in-vitro study. Angiology. 1998;49:777-88.

Lele PP. Production of deep focal lesions by focused ultrasound - current status. Ultrasonics. 1967;5:105-12.

Fry FJ, Kossoff G, Eggleton RC, Dunn F. Threshold ultrasonic dosages for structural changes in the mammalian brain. J Acoust Soc Am.. 1970;48.

Schultz-Haakh H, Li JK, Welkowitz W, Rosenberg N. Ultrasonic treatment of varicose veins. Angiology. 1989;40:129-37.

Yang R, Grififith SL, Rescorla FJ. Feasibility of using high intensity focused ultrasound for the treatment of unresectable retroperitoneal malignancies. . 1992.

Seidl M, Steinbach P, Hofstadter F. Shock wave induced endothelial damage: in situ analysis by confocal laser microscopy. Ultrasound Med Biol.. 1994;20:571-8.

Delon-Martin C, Vogt C, Chignier E, Guers C, Chapelon JY, Cathignol D. Venous thrombosis generation by means of high-intensity focused ultrasound. Ultrasound Med Biol.. 1995;21:113-9.

Hynynen K, Chung AH, Colucci V, Jolesz FA. Potential adverse effects of high-intensity focused ultrasound exposure on blood vessels in vivo. Ultrasound Med Biol.. 1996;22:193-201.

Breu FX, Guggenbichler S. European Consensus Meeting on Foam Sclerotherapy. Dermatol Surg.. 2004;30:709-17.

Pitta GBB, Castro AA, Teixeira LR, Francisco Jr J, Miranda Jr F, Burihan E. Preservation of the greater saphenous vein in primary troncular varicose vein surgery. J Vasc Bras.. 2002;1:32-38.

Weiss RA. Endovenous techniques for elimination of saphenous reflux: a valuable treatment modality. Dermatol Surg.. 2001;27:902-5.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">

Métodos físicos utilizados para oclusão de varizes dos membros inferiores

Physical methods used to promote occlusion of varicose veins of the lower limbs

Marcelo Araújo; Fermin de C. Garcia Velasco

Resumo

Palavras-chave

Abstract

Keywords

Referências

Links

Compartilhar

J Vasc Bras