varicose veins

[jayci]

What is the thai name for varicose veins. Thanks

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[Somnambulist]

https://translate.google.com/#auto/th/varicose%20veins

[Lumbini]

Any top Dr.'s here for this as there are new treatments that make stripping vein unneeded . I was waiting to address this for myself until Dr.'s here had more experience with the new procedure and decided to chime in here .

What we think we become ...

[jayci]

Yeah, I heard that the treatment was just a simple injection in the affected vein.

Sent from my GT-N7100 using Thaivisa Connect Thailand mobile app

[wordchild]

If you search for Varithena, which is a polidoconal injectable foam, there are others types (and some docs in the UK and US mix their own) but this one has now got FDA approval after lengthy trials, so safer. Invented by a Spanish doctor and developed by a small British drug company (BTG). Now being marketed in the US and also available in some specialist vein clinics in Europe.I very much doubt it is available in Thailand yet, although many clinics ,I believe, use polidocanol (in liquid form) to treat spider veins. Just injecting liquid polidocanol is not very effective in treating large veins, but in foam form it seems to be pretty effective.

[Sheryl]

There are several treatments for varicose veins, it depends on the location and severity among other things. Treatments include ablation (laser or RF), sclerotherapy or surgery. There is no single "one size fits all" solution.

The Yanhee website has a good overview of the various treatments and their pros and cons http://www.yanhee.net/treatment-procedure/varicose-veins

Polidocanol foam (a sclerosing agent) is being used by at least some of the specialists here. I know the legvein clinic in CM has it and have the impression they have it at Yanhee as well. But note that some people might be better off with laser or Rf ablation.

[wordchild]

Sheryl is right,of course,there are other treatment options, however it is also the case that many doctors tend to go with the treatment option they are most familiar with and therefore confident in and can sometimes be reluctant to use something new.It also seems to be the case that some vascular surgeons have been resistant to using foam injections because it ,to some extent, deskills their role (and may also be less renumerative). In its extensive trials, over many years, Varithena displayed pretty impressive results against all the other treatment options and it is (so far) the only polidocanol foam to have received FDA approval. The main advantage over surgery, from the patient perspective, is it can be done, without special preparation, in a consulting room, and the patient can go straight home after the procedure, rest for a day or so (as a precaution) and can then restart their normal activity. Anyone who has had surgery for varicose veins will know its pretty painfull and also puts you out of action for several days.

Edited June 17, 2014 by wordchild

[Sheryl]

Most of those same advantages would also apply to laser or RF ablation.

[Lumbini]

Very helpful tread ( thank you. ) as I look for most experienced Dr. in Bangkok to preform my RF on varicose veins in one leg . I had many appointments and still not find the " go to guy " with much experience in RF that I would choose over lasers ablation . If anyone knows a Dr. with much experience in this please let me know. . Below is recent article about study done comparing RF to laser. .

— Although radiofrequency is technically equivalent to lasers for ablation of the incompetent greater saphenous vein, laser ablation caused more pain and bruising in a randomized trial, researchers reported here at the Society of Interventional Radiology (SIR) 37th Annual Meeting.

"It took significantly longer to perform the laser procedure and there was a significant increase in post-procedure bruising in the laser group," said Malcolm Sydnor Jr, MD, an assistant professor of radiology and surgery at Virginia Commonwealth University in Richmond, in presenting the data.

Both radiofrequency and laser endovenous thermal ablation are accepted treatments for the refluxing greater saphenous vein in symptomatic patients, but neither technology has been definitively proved to have fewer complications or superior results.

In this study, the researchers compared the 2 modalities in terms of technical success, major complications (including deep-vein thrombosis), and patient satisfaction.

The researchers randomly divided 200 patients into 2 groups, 100 to each modality. The patients' average Clinical Severity Etiology Anatomy Pathophysiology classification was 3.09 and their average Venous Clinical Severity Score (VCSS) was 6.23.

Patients were seen at 1 week, 6 weeks, and 6 months and are continuing to be followed. Sonograms and data on patient satisfaction are obtained.

Primary data points are technical success (which was positive if the greater saphenous vein remained closed with no neovascularity), absence of deep-vein thrombosis, and patient satisfaction.

The researchers performed laser ablation with an AngioDynamics EVLT 980-nm diode. They performed radiofrequency ablation with a VNUS Medical Technologies system.

All the procedures were performed by 1 of 2 radiologists.

"It took significantly less time to perform the procedure with radiofrequency ablation," said Dr. Sydnor.

At 1-week follow-up, there were no deep-vein thromboses and 100% closure according to ultrasonography results in both groups.

"Of note, there was a significant increase in post-procedure bruising in the laser group relative to the radiofrequency ablation group," said Dr. Sydnor. "This was recorded by both the objective data on a scale of 1-10 and subjective data on a scale of 1-10 as judged by a nurse practitioner in a blinded fashion." The difference was statistically significant (P < .0019).

There were no other significant differences between the 2 groups, and patient satisfaction was high in both.

Asked to explain the difference in pain and bruising, Dr. Sydnor said, "It's postulated that because of the mechanism there are more perforations of the vein wall itself so you get more bruising and pain around the vein wall as opposed to the RF [radiofrequency], which is operated at more consistent temperatures."

At 6 weeks' follow-up, 1 technical failure had occurred in each group. There were still no deep-vein thromboses or neovascularity, and no significant differences were seen for any other factor.

At 6 months' follow-up, 2 additional technical failures had occurred in the radiofrequency group. No deep-vein thromboses had developed, and patient satisfaction remained high.

The VCSS over time showed significant improvement, dropping to about 2 in both groups at the most recent follow-ups. This measure did not significantly differ between the 2 groups.

To date, there have been a total of 4 failures in the radiofrequency group and 1 in the laser group. This difference is not statistically significant.

Session moderator Mark Garcia, MD, section chief of interventional radiology at Christiana Care in Newark, Delaware, commented that the larger number of technical failures in the radiofrequency group might become significant with a larger group.

http://www.medscape.com/viewarticle/761257

Sent from my iPhone using Thaivisa Connect Thailand

[Lumbini]

Was told at hospital best way to determine best procedure is get to root of cause with ultrasound exam of both legs .

Sent from my iPhone using Thaivisa Connect Thailand