nach oben

Indian Journal of Surgery

Erschienen in:

20.05.2022 | Review Article

Endovenous Laser Ablation for Varicose Vein Treatment: A Systematic Review and Meta-Analysis

verfasst von: Mohammad Karimian, Samira Tardeh, Zeinab Tardeh

Erschienen in: Indian Journal of Surgery | Sonderheft 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Varicose veins are among the common problems affecting the quality of life. Endovenous laser ablation (EVLA) has been introduced as a noninvasive treatment for varicose veins. This study was performed according to the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) protocol, and the results were reported based on Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. MeSH keywords were searched in several online databases. Heterogeneity among studies was assessed using Cochran's Q test and I² index, and the random-effects model. Data were analyzed using Comprehensive Meta-analysis software version 2. EVLA success, recurrence and recanalization rates were 94.5%, 10.3% and 3.6%, respectively. EVLA complications in the treatment of varicose veins were ecchymosis (41.3%), pain (26.1%), bruising (24.2%), induration (22.7%), edema (8.3%), phlebitis (4.8%), dyspigmentation (4.1%), venous thrombosis (3.7%), thrombophlebitis (3.7%), paresthesia (3.1%), thermal injury (1.8%), hematoma (1.7%), cellulitis (1.4%), bleeding (0.9%), infection (0.9%), nerve injury (0.9%), deep vein thrombosis (DVT) (0.6%) and pulmonary thromboembolism (PTE) (0.4%). The success rate of EVLA increased with an increase in wavelength and peaked at 1470 nm (nm). The highest rate of recurrence and recanalization was at 810 nm and 940 nm, and the lowest was at 1470 nm. EVLA is an effective, less invasive and mostly safe treatment with no need to general anesthesia and also minor complications. The follow-up duration and geographical location of studies also provide insight into the differences in success rate, recurrence and recanalization rate of EVLA.

Nur mit Berechtigung zugänglich

Sybrandy JE, Wittens CH (2002) Initial experiences in endovenous treatment of saphenous vein reflux. J Vasc Surg 36(6):1207–1212PubMedCrossRef

Margolisa DJ et al (2002) Venous leg ulcer: incidence and prevalence in the elderly. J Am Acad Dermatol 46(3):381–386CrossRef

Köroglu M et al (2011) Endovenous laser ablation and foam sclerotherapy for varicose veins: does the presence of perforating vein insufficiency affect the treatment outcome? Acta Radiol 52(3):278–284PubMedCrossRef

Rasmussen LH et al (2007) Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: short-term results. J Vasc Surg 46(2):308–315PubMedCrossRef

Weiss RA, Weiss MA (2002) 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 28(1):38–42PubMed

Bone C (1999) Tratamiento endoluminal de las varices con laser de diodo. Estudio preliminar. Rev Patol Vasc. pp. 35–46

Proebstle T et al (2003) Infrequent early recanalization of greater saphenous vein after endovenous laser treatment. J Vasc Surg 38(3):511–516PubMedCrossRef

Disselhoff B et al (2009) Randomised comparison of costs and cost-effectiveness of cryostripping and endovenous laser ablation for varicose veins: 2-year results. Eur J Vasc Endovasc Surg 37(3):357–363PubMedCrossRef

Lattimer C et al (2012) Cost and effectiveness of laser with phlebectomies compared with foam sclerotherapy in superficial venous insufficiency. Early results of a randomised controlled trial. Eur J Vasc Endovasc Surg 43(5):594–600PubMedCrossRef

10.

Tellings S, Ceulen R, Sommer A (2011) Surgery and endovenous techniques for the treatment of small saphenous varicose veins: a review of the literature. Phlebology 26(5):179–184PubMedCrossRef

11.

Bozoglan O et al (2016) Comparison of endovenous laser and radiofrequency ablation in treating varicose veins in the same patient. Vasc Endovasc Surg 50(1):47–51CrossRef

12.

Lawaetz M et al (2017) Comparison of endovenous ablation techniques, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Extended 5-year follow-up of a RCT. J Vasc Surg: Venous Lymphat Disord 5(6):907–908

13.

Stroup DF et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 283(15):2008–2012PubMedCrossRef

14.

Moher D et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4(1):1–9PubMedPubMedCentralCrossRef

15.

Wells GA et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2000, Oxford

16.

Higgins J (2011) Cochrane handbook for systematic reviews of interventions. Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration. www. cochrane-handbook. org,

17.

Oğuzkurt L (2012) Endovenous laser ablation for the treatment of varicose veins. Diagn Interv Radiol 18(4):417–422PubMed

18.

Van den Bos R et al (2008) Technical review of endovenous laser therapy for varicose veins. Eur J Vasc Endovasc Surg 35(1):88–95PubMedCrossRef

19.

Darwood R, Gough M (2009) Endovenous laser treatment for uncomplicated varicose veins. Phlebology 24(1_suppl):50–61PubMedCrossRef

20.

Mundy L et al (2005) Systematic review of endovenous laser treatment for varicose veins. J Br Surg 92(10):1189–1194CrossRef

21.

Siribumrungwong B et al (2012) A systematic review and meta-analysis of randomised controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Eur J Vasc Endovasc Surg 44(2):214–223PubMedCrossRef

22.

Pan Y et al (2014) Comparison of endovenous laser ablation and high ligation and stripping for varicose vein treatment: a meta-analysis. Phlebology 29(2):109–119PubMedCrossRef

23.

Balint R et al (2016) Which endovenous ablation method does offer a better long-term technical success in the treatment of the incompetent great saphenous vein? Rev Vascr 24(6):649–657

24.

Almeida JI, Raines JK (2006) Radiofrequency ablation and laser ablation in the treatment of varicose veins. Ann Vasc Surg 20(4):547–552PubMedCrossRef

25.

Biemans AA et al (2013) Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg 58(3):727–34.e1PubMedCrossRef

26.

Disselhoff BC et al (2011) Five-year results of a randomized clinical trial comparing endovenous laser ablation with cryostripping for great saphenous varicose veins. Br J Surg 98(8):1107–1111PubMedCrossRef

27.

Eissawy M et al. (2015) Endovenous laser ablation of varicose veins. Egypt J Radiol Nucl Medicine 47(1)

28.

Perkowski P et al (2004) Endovenous laser ablation of the saphenous vein for treatment of venous insufficiency and varicose veins: early results from a large single-center experience. J Endovasc Ther 11(2):132–138PubMedCrossRef

29.

Satokawa H et al (2010) Comparison of endovenous laser treatment for varicose veins with high ligation using pulse mode and without high ligation using continuous mode and lower energy. Ann Vasc Dis 3(1):46–51PubMedPubMedCentralCrossRef

30.

Huang Y et al (2005) Endovenous laser treatment combined with a surgical strategy for treatment of venous insufficiency in lower extremity: a report of 208 cases. J Vasc Surg 42(3):494–501PubMedCrossRef

31.

Gibson KD et al (2007) Endovenous laser treatment of the short saphenous vein: efficacy and complications. J Vasc Surg 45(4):795–803PubMedCrossRef

32.

Park SW et al (2008) Endovenous laser ablation of the incompetent small saphenous vein with a 980-nm diode laser: our experience with 3 years follow-up. Eur J Vasc Endovasc Surg 36(6):738–742PubMedCrossRef

33.

Disselhoff BC et al (2008) Randomized clinical trial comparing endovenous laser ablation of the great Saphenous vein with and without ligation of the sapheno-femoral junction: 2-year results. Eur J Vasc Endovasc Surg 36(6):713–718PubMedCrossRef

34.

Hirokawa M et al (2015) Comparison of 1470 nm laser and radial 2ring fiber with 980 nm laser and bare-tip fiber in endovenous laser ablation of saphenous varicose veins: a multicenter, prospective, randomized, non-blind study. Ann Vasc Dis 8(4):282–289PubMedPubMedCentralCrossRef

35.

Beyazal M et al. (2014) Endovenous laser ablation treatment with 980 nm diode laser for saphenous vein insufficiency: 6 months follow up results

36.

Maurins U, Rabe E, Pannier F (2009) Does laser power influence the results of endovenous laser ablation (EVLA) of incompetent saphenous veins with the 1 470-nm diode laser? A prospective randomized study comparing 15 and 25 W. Int Angiol 28(1):32–37PubMed

37.

Flessenkämper I et al (2016) Endovenous laser ablation with and without high ligation compared to high ligation and stripping for treatment of great saphenous varicose veins: results of a multicentre randomised controlled trial with up to 6 years follow-up. Phlebology 31(1):23–33PubMedCrossRef

38.

Sydnor M et al (2017) A randomized prospective long-term (> 1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980 nm laser ablation of the great saphenous vein. Phlebology 32(6):415–424PubMedCrossRef

39.

Cavallini A, Marcer D, Ferrari Ruffino S (2018) Endovenous laser treatment of groin and popliteal varicose veins recurrence. Phlebology 33(3):195–205PubMedCrossRef

40.

Zafarghandi MR et al (2009) Endovenous laser ablation (EVLA) in patients with varicose great saphenous vein (GSV) and incompetent saphenofemoral junction (SFJ): an ambulatory single center experience. Vasc Endovasc Surg 43(2):178–184CrossRef

41.

Woźniak W, Mlosek RK, Ciostek P (2016) Complications and failure of endovenous laser ablation and radiofrequency ablation procedures in patients with lower extremity varicose veins in a 5-year follow-up. Vasc Endovasc Surg 50(7):475–483CrossRef

42.

Altin FH et al (2015) Endovenous laser ablation for saphenous vein insufficiency: Short-and mid-term results of 230 procedures. Vascular 23(1):3–8PubMedCrossRef

43.

Vuylsteke M et al (2006) Endovenous laser obliteration for the treatment of primary varicose veins. Phlebology 21(2):80–87CrossRef

44.

Varetto G. et al. (2013) Ultrasound surveillance in endoluminal laser treatment for varicose veins

45.

Pannier F, Rabe E, Maurins U (2009) First results with a new 1470-nm diode laser for endovenous ablation of incompetent saphenous veins. Phlebology 24(1):26–30PubMedCrossRef

46.

Rass K et al (2012) Comparable effectiveness of endovenous laser ablation and high ligation with stripping of the great saphenous vein: two-year results of a randomized clinical trial (RELACS study). Arch Dermatol 148(1):49–58PubMedCrossRef

47.

Venermo M et al (2016) Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy for the treatment of great saphenous varicose veins. J Br Surgery 103(11):1438–1444CrossRef

48.

van den Bos RR et al (2014) Randomized clinical trial of endovenous laser ablation versus steam ablation (LAST trial) for great saphenous varicose veins. Br J Surg 101(9):1077–1083PubMedCrossRef

49.

Disselhoff BC, Der Kinderen DJ, Moll FL (2005) Is there recanalization of the great saphenous vein 2 years after endovenous laser treatment? J Endovasc Ther 12(6):731–738PubMedCrossRef

50.

Disselhoff B et al (2008) Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins. Journal of British Surgery 95(10):1232–1238CrossRef

51.

Min RJ, Khilnani N, Zimmet SE (2003) Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol 14(8):991–996PubMedCrossRef

52.

Golbasi I et al (2015) Endovenous laser with miniphlebectomy for treatment of varicose veins and effect of different levels of laser energy on recanalization A single center experience. Lasers Med Sci 30(1):103–108PubMedCrossRef

53.

何蓓, et al., (2009) Day surgery varicose vein treatment using endovenous laser. Hong Kong Med J 15(1): p. 39–43

54.

Tan K, Nalachandran S, Chia K (2009) Endovenous laser treatment for varicose veins in Singapore: a single centre experience of 169 patients over two years. Singapore Med J 50(6):591PubMed

55.

Myers K, Fris R, Jolley D (2006) Treatment of varicose veins by endovenous laser therapy: assessment of results by ultrasound surveillance. Med J Aust 185(4):199–202PubMedCrossRef

56.

Navarro L, Min RJ, Boné C (2001) Endovenous laser: a new minimally invasive method of treatment for varicose veins—preliminary observations using an 810 nm diode laser. Dermatol Surg 27(2):117–122PubMed

57.

Kavuturu S, Girishkumar H, Ehrlich F (2006) Endovenous laser ablation of saphenous vein is an effective treatment modality for lower extremity varicose veins. Am Surg 72(8):672–676PubMedCrossRef

58.

Rasmussen LH et al (2011) Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg 98(8):1079–1087PubMedCrossRef

59.

Rasmussen L et al (2013) Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous Lymphat Disord 1(4):349–356PubMedCrossRef

60.

Mozafar M et al (2014) Endovenous laser ablation of the great saphenous vein versus high ligation: long-term results. Lasers Med Sci 29(2):765–771PubMedCrossRef

61.

Mendes-Pinto D et al (2016) Endovenous laser ablation of the great saphenous vein comparing 1920-nm and 1470-nm diode laser. Int Angiol 35(6):599–604PubMed

62.

ETLİK Ö et al (2013) Endovenous laser ablation for saphenous vein insufficiency: long-term results. Turk J Med Sci 43(3):470–473

63.

Nandhra S et al (2015) A randomized clinical trial of endovenous laser ablation versus conventional surgery for small saphenous varicose veins. J Vasc Surg 61(3):741–746PubMedCrossRef

64.

Rasmussen L et al (2013) Randomized clinical trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years. J Vasc Surg 58(2):421–426PubMedCrossRef

65.

Kalteis M et al (2008) High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: early results of a randomized controlled study. J Vasc Surg 47(4):822–829PubMedCrossRef

66.

Lu X et al (2008) Endovenous ablation with laser for great saphenous vein insufficiency and tributary varices: a retrospective evaluation. J Vasc Surg 48(3):675–679PubMedCrossRef

67.

Christenson JT et al (2010) Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up. J Vasc Surg 52(5):1234–1241PubMedCrossRef

68.

Theivacumar N, Gough M (2011) Endovenous laser ablation (EVLA) to treat recurrent varicose veins. Eur J Vasc Endovasc Surg 41(5):691–696PubMedCrossRef

69.

Samuel N et al (2013) Randomized clinical trial of endovenous laser ablation versus conventional surgery for small saphenous varicose veins. Ann Surg 257(3):419–426PubMedCrossRef

70.

Fernández CF, Roizental M, Carvallo J (2008) Combined endovenous laser therapy and microphlebectomy in the treatment of varicose veins: efficacy and complications of a large single-center experience. J Vasc Surg 48(4):947–952PubMedCrossRef

71.

Myers K, Jolley D (2009) Outcome of endovenous laser therapy for saphenous reflux and varicose veins: medium-term results assessed by ultrasound surveillance. Eur J Vasc Endovasc Surg 37(2):239–245PubMedCrossRef

72.

Agus G, Mancini S, Magi G (2006) The first 1000 cases of Italian Endovenous-laser Working Group (IEWG). Rationale, and long-term outcomes for the 1999–2003 period. Int Angiol 25(2):209PubMed

73.

Doganci S, Demirkilic U (2010) Comparison of 980 nm laser and bare-tip fibre with 1470 nm laser and radial fibre in the treatment of great saphenous vein varicosities: a prospective randomised clinical trial. Eur J Vasc Endovasc Surg 40(2):254–259PubMedCrossRef

74.

Huisman L et al (2009) Endovenous laser ablation of the small saphenous vein: prospective analysis of 150 patients, a cohort study. Eur J Vasc Endovasc Surg 38(2):199–202PubMedCrossRef

75.

Park SJ et al (2008) Endovenous Laser Treatment of the Small Saphenous Vein with a 980-nm Diode Laser: Early Results. Dermatol Surg 34(4):517–524PubMed

76.

Theivacumar N et al (2007) Initial experience in endovenous laser ablation (EVLA) of varicose veins due to small saphenous vein reflux. Eur J Vasc Endovasc Surg 33(5):614–618PubMedCrossRef

77.

Proebstle TM et al (2003) Endovenous laser treatment of the lesser saphenous vein with a 940-nm diode laser: early results. Dermatol Surg 29(4):357–361PubMed

78.

Desmyttere J et al (2010) Endovenous laser ablation (980 nm) of the small saphenous vein in a series of 147 limbs with a 3-year follow-up. Eur J Vasc Endovasc Surg 39(1):99–103PubMedCrossRef

79.

Desmyttère J et al (2007) Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg 46(6):1242–1247PubMedCrossRef

80.

Doganci S, Yildirim V, Demirkilic U (2011) Does puncture site affect the rate of nerve injuries following endovenous laser ablation of the small saphenous veins? Eur J Vasc Endovasc Surg 41(3):400–405PubMedCrossRef

81.

Min RJ et al (2001) Endovenous laser treatment of the incompetent greater saphenous vein. J Vasc Interv Radiol 12(10):1167–1171PubMedCrossRef

82.

Proebstle T et al (2002) Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg 35(4):729–736PubMedCrossRef

83.

Proebstle TM et al (2004) Nonocclusion and early reopening of the great saphenous vein after endovenous laser treatment is fluence dependent. Dermatol Surg 30(2):174–178PubMed

84.

Sharif M et al (2006) Endovenous laser treatment for long saphenous vein incompetence. J Br Surg 93(7):831–835CrossRef

85.

Gerard J et al (2002) Feasibility of ambulatory endovenous laser for the treatment of greater saphenous varicose veins: one-month outcome in a series of 20 outpatients. J Mal Vasc 27(4):222–225PubMed

86.

Sadick NS, Wasser S (2004) Combined endovascular laser with ambulatory phlebectomy for the treatment of superficial venous incompetence: a 2-year perspective. J Cosmet Laser Ther 6(1):44–49PubMedCrossRef

87.

Timperman PE (2005) Prospective evaluation of higher energy great saphenous vein endovenous laser treatment. J Vasc Interv Radiol 16(6):791–794PubMedCrossRef

88.

Puggioni A et al (2005) Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg 42(3):488–493PubMedCrossRef

89.

Elmore FA, Lackey D (2008) Effectiveness of endovenous laser treatment in eliminating superficial venous reflux. Phlebology 23(1):21–31PubMedCrossRef

90.

Van den Bremer J et al (2009) Implementation of endovenous laser ablation for varicose veins in a large community hospital: the first 400 procedures. Eur J Vasc Endovasc Surg 37(4):486–491PubMedCrossRef

91.

Kontothanassis D et al (2009) Endovenous laser treatment of the small saphenous vein. J Vasc Surg 49(4):973-979. e1PubMedCrossRef

92.

Knipp BS et al (2008) Endovenous laser ablation: venous outcomes and thrombotic complications are independent of the presence of deep venous insufficiency. J Vasc Surg 48(6):1538–1545PubMedCrossRef

93.

Mackenzie R et al (2009) Introducing endovenous laser therapy ablation to a National Health Service vascular surgical unit–the Aberdeen experience. Eur J Vasc Endovasc Surg 38(2):208–212PubMedCrossRef

94.

Theivacumar N et al (2008) Factors influencing the effectiveness of endovenous laser ablation (EVLA) in the treatment of great saphenous vein reflux. Eur J Vasc Endovasc Surg 35(1):119–123PubMedCrossRef

95.

Gonzalez-Zeh R, Armisen R, Barahona S (2008) Endovenous laser and echo-guided foam ablation in great saphenous vein reflux: one-year follow-up results. J Vasc Surg 48(4):940–946PubMedCrossRef

96.

Nwaejike N, Srodon P, Kyriakides C (2009) Endovenous laser ablation for short saphenous vein incompetence. Ann Vasc Surg 23(1):39–42PubMedCrossRef

97.

Goode S et al (2010) Laser and radiofrequency ablation study (LARA study): a randomised study comparing radiofrequency ablation and endovenous laser ablation (810 nm). Eur J Vasc Endovasc Surg 40(2):246–253PubMedCrossRef

98.

Vuylsteke M et al (2011) Endovenous laser treatment: is there a clinical difference between using a 1500 nm and a 980 nm diode laser? A multicenter randomised clinical trial. Int Angiol 30(4):327PubMed

99.

Samuel N et al (2013) Comparison of 12-w versus 14-w endovenous laser ablation in the treatment of great saphenous varicose veins: 5-year outcomes from a randomized controlled trial. Vasc Endovasc Surg 47(5):346–352CrossRef

100.

Mese B et al (2015) A comparison of 1,470-nm endovenous laser ablation and radiofrequency ablation in the treatment of great saphenous veins 10 mm or more in size. Ann Vasc Surg 29(7):1368–1372PubMedCrossRef

101.

Spreafico G et al (2014) Endovenous laser ablation of great and small saphenous vein incompetence with a 1470-nm laser and radial fiber. J Vasc Surg Venous Lymphat Disord 2(4):403–410PubMedCrossRef

102.

Proebstle TM et al (2005) Endovenous treatment of the great saphenous vein using a 1,320 nm Nd: YAG laser causes fewer side effects than using a 940 nm diode laser. Dermatol Surg 31(12):1678–1684PubMed

Titel: Endovenous Laser Ablation for Varicose Vein Treatment: A Systematic Review and Meta-Analysis
verfasst von: Mohammad Karimian
Samira Tardeh
Zeinab Tardeh
Publikationsdatum: 20.05.2022
Verlag: Springer India
Erschienen in: Indian Journal of Surgery / Ausgabe Sonderheft 1/2023
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI: https://doi.org/10.1007/s12262-022-03441-0

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Endovenous Laser Ablation for Varicose Vein Treatment: A Systematic Review and Meta-Analysis

Abstract

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 1/2023

The Role of Serum Apelin Levels in Peripheral Artery Disease

Bacteriological Study of Varicose Vein Specimens

Varicose Veins—How to Investigate

Saccoid Aneurysm: a Rare Complication of Plaque Rupture

Correction to: Effectiveness of a Brief Teaching Scenario in a Phantom-Based Learning Model for Students to Achieve Ultrasound-Guided Vascular Access—A Prospective Study

Endovenous Treatment for Varicose Veins

Update Chirurgie