RESUMO
OBJECTIVE: Minimally invasive techniques have been increasingly used to treat pathologic perforator veins (PVs). The goal of the present study was to summarize the current literature and determine the outcomes of treating PVs with or without the great saphenous vein/small saphenous vein using endovenous laser ablation (EVLA), radiofrequency ablation (RFA), and ultrasound-guided sclerotherapy (USGS). METHODS: A systematic review of the literature on the percutaneous treatment of PVs (35 studies) was conducted in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. Studies reported up to March 2020 were included. The incidence of several end points at different follow-up periods were calculated according to the availability of data within 3 to 12 months after the index procedure. RESULTS: Of the 35 studies, 15 (n = 1677) had reported on EVLA with or without sclerotherapy and/or microphlebectomy, 12 (n = 1477) had investigated the outcomes of RFA ablation with/without sclerotherapy, and 8 (n = 331) had investigated USGS alone. All techniques were safe in terms of periprocedural adverse events, with only a few complications occurring in each group. Immediate procedural success (within 30 days) was 95% in the EVLA group, 91% in the RFS group, and 58% to 70% in the USGS group. At 12 months of follow-up, the occlusion rates were 89%, 77%, and 83% in the EVLA, RFA, and USGS groups, respectively. The 12-month pooled estimate of ulcer healing between the EVLA and RFA groups was similar, although no direct comparisons were performed. CONCLUSIONS: Treatment of PVs with percutaneous techniques, such as EVLA, RFA, and USGS, is safe and associated with high technical success. EVLA and RFA exhibited the most favorable outcomes. Additional research is needed to validate these results, which were based on the limited level of evidence available to better determine the most optimal treatment approach for lower limb pathologic PVs.
Assuntos
Ablação por Cateter , Terapia a Laser , Varizes , Insuficiência Venosa , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Veia Safena/diagnóstico por imagem , Veia Safena/cirurgia , Escleroterapia/efeitos adversos , Escleroterapia/métodos , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/cirurgia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/etiologia , Insuficiência Venosa/terapiaRESUMO
Persistent sciatic vein is a rare anomaly of mesodermal development. When found, it is often associated with varicosities in abnormal distributions, pain, limb congestion, and hypertrophy. In this report, we describe a case of an isolated, complete persistent sciatic vein with an atypical anatomy and onset.