血管内レーザー治療の位置づけ—大腿ストリッピング手術との比較検討
要旨：980-nm ダイオードレーザーによる血管内レーザー治療（EV 群）と大腿ストリッピング（ST 群）の治療成績，静脈機能を比較検討した。両群ともに初期成功率100％で，重大な合併症はなかった。EV 群は94.3％の症例で術前の自覚症状が軽快し，術後12 カ月で血管閉塞率98％，EHIT 合併11.9％（Class 3：0.7％）であった。空気容積脈波法による静脈機能の検討では，両群ともに術後有意に改善したが，EV 群の静脈機能の改善はST 群には及ばなかった。...
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| Published in | 脈管学 Vol. 55; no. 2; pp. 13 - 20 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脈管学会
2015
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-1126 1880-8840 |
| DOI | 10.7133/jca.14-00016 |
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| Abstract | 要旨：980-nm ダイオードレーザーによる血管内レーザー治療（EV 群）と大腿ストリッピング（ST 群）の治療成績，静脈機能を比較検討した。両群ともに初期成功率100％で，重大な合併症はなかった。EV 群は94.3％の症例で術前の自覚症状が軽快し，術後12 カ月で血管閉塞率98％，EHIT 合併11.9％（Class 3：0.7％）であった。空気容積脈波法による静脈機能の検討では，両群ともに術後有意に改善したが，EV 群の静脈機能の改善はST 群には及ばなかった。 |
|---|---|
| AbstractList | 要旨：980-nm ダイオードレーザーによる血管内レーザー治療（EV 群）と大腿ストリッピング（ST 群）の治療成績，静脈機能を比較検討した。両群ともに初期成功率100％で，重大な合併症はなかった。EV 群は94.3％の症例で術前の自覚症状が軽快し，術後12 カ月で血管閉塞率98％，EHIT 合併11.9％（Class 3：0.7％）であった。空気容積脈波法による静脈機能の検討では，両群ともに術後有意に改善したが，EV 群の静脈機能の改善はST 群には及ばなかった。 |
| Author | 種本, 和雄 滝内, 宏樹 田淵, 篤 正木, 久男 古川, 博史 小島, 健次 柚木, 靖弘 山澤, 隆彦 渡部, 芳子 本田, 威 桒田, 憲明 |
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| References | 3) Miyazaki K, Nishibe T, Sata F, et al: Long-term results of treatments for varicose veins due to greater saphenous vein insufficiency. Int Angiol 2005; 24: 282–286 5) 田淵篤，正木久男，柚木靖弘，他：下腿部大伏在静脈本幹への硬化療法を併用した大腿ストリッピング手術の治療成績．脈管学 2010; 50: 747–752 16) Mozafar M, Atqiaee K, Haghighatkhah H, et al: Endovenous laser ablation of the great saphenous vein versus high ligation: long-term results. Laser Med Sci 2014; 29: 765–771 1) Sarin S, Scurr JH, Coleridge Smith PD: Stripping of the long saphenous vein in the treatment of primary varicose veins. Br J Surg 1994; 81: 1455–1458 20) Pronk P, Gauw SA, Mooij MC, et al: Randomised controlled trial comparing sapheno-femoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anaesthesia: one year results. Eur J Vasc Endovasc Surg 2010; 40: 649–656 23) Siribumrungwong B, Noorit P, Wilasrusmee C, et al: 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 2012; 44: 214–223 4) 田淵篤，正木久男，柚木靖弘，他：下腿部本幹硬化療法を併用した大腿ストリッピング手術の治療成績．静脈学 2011; 22: 11–16 11) Scarpelli P, Maggipinto A, Leopardi M, et al: An update in varicose vein pathology after ten years of endovenous laser therapy (EVLT) with a 980 nm diode laser: clinical experience of a single center. Laser Ther 2013; 22: 269–273 7) 田淵篤，正木久男，柚木靖弘，他：大伏在静脈瘤に対する各種術式の治療成績．静脈学2013; 24: 91–99 18) Rasmussen LH, Bjoern L, Lawaetz M, et al: Randomised clinical trial comparing endovenous laser ablation with stripping of the great saphenous vein: clinical outcome and recurrence after 2 years. Eur J Vasc Endovasc Surg 2010; 39: 630–635 22) Rasmussen L, Lawaetz M, Bjoern L, et al: 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 2013; 58: 421–426 10) 広川雅之，栗原伸久：下肢静脈瘤に対する980 nm レーザーを用いた標準的血管内レーザー治療．日血外会誌2012; 21: 583–588 21) Flessenkämper I, Hartmann M, Stenger D, et al: Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial. Phlebology 2013; 28: 16–23 2) Rutgers PH, Kitslaar PJ: Randomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg 1994; 168: 311–315 19) Christenson JT, Gueddi S, Gemayel G, et al: 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 2010; 52: 1234–1241 8) Christopoulos DG, Nicolaides AN, Szendro G, et al: Air-plethysmography and the effect of elastic compression on venous hemodynamics of the leg. J Vasc Surg 1987; 5: 148–159 24) Murad MH, Coto-Yglesias F, Zumaeta-Garcia M, et al: A systematic review and meta-analysis of the treatment of varicose veins. J Vasc Surg 2011; 53 (5 Suppl): 49S–65S 6) 田淵篤，正木久男，柚木靖弘，他：下腿部大伏在静脈本幹へのフォーム硬化療法を併用した大腿ストリッピング手術の治療成績―ポリドカノール濃度の違いによる治療成績の検討―．静脈学 2013; 24: 23–30 14) Pannier F, Rabe E: Mid-term results following endovenous laser ablation (EVLA) of saphenous veins with a 980 nm diode laser. Int Angiol 2008; 27: 475–481 13) Rasmussen LH, Bjoern L, Lawaetz M, et al: 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 2007; 46: 308–315 12) Desmyttère J, Grard C, Wassmer B, et al: Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg 2007; 46: 1242–1247 9) Nicolaides AN; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery, et al: Investigation of chronic venous insufficiency: A consensus statement. Circulation 2000; 102: E126–163 15) Doganci S, Demirkilic U: 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 2010; 40: 254–259 17) Mozes G, Kalra M, Carmo M, et al: Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques. J Vasc Surg 2005; 41: 130–135 |
| References_xml | – reference: 21) Flessenkämper I, Hartmann M, Stenger D, et al: Endovenous laser ablation with and without high ligation compared with high ligation and stripping in the treatment of great saphenous varicose veins: initial results of a multicentre randomized controlled trial. Phlebology 2013; 28: 16–23 – reference: 5) 田淵篤，正木久男，柚木靖弘，他：下腿部大伏在静脈本幹への硬化療法を併用した大腿ストリッピング手術の治療成績．脈管学 2010; 50: 747–752 – reference: 9) Nicolaides AN; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery, et al: Investigation of chronic venous insufficiency: A consensus statement. Circulation 2000; 102: E126–163 – reference: 15) Doganci S, Demirkilic U: 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 2010; 40: 254–259 – reference: 11) Scarpelli P, Maggipinto A, Leopardi M, et al: An update in varicose vein pathology after ten years of endovenous laser therapy (EVLT) with a 980 nm diode laser: clinical experience of a single center. Laser Ther 2013; 22: 269–273 – reference: 6) 田淵篤，正木久男，柚木靖弘，他：下腿部大伏在静脈本幹へのフォーム硬化療法を併用した大腿ストリッピング手術の治療成績―ポリドカノール濃度の違いによる治療成績の検討―．静脈学 2013; 24: 23–30 – reference: 19) Christenson JT, Gueddi S, Gemayel G, et al: 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 2010; 52: 1234–1241 – reference: 17) Mozes G, Kalra M, Carmo M, et al: Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques. J Vasc Surg 2005; 41: 130–135 – reference: 13) Rasmussen LH, Bjoern L, Lawaetz M, et al: 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 2007; 46: 308–315 – reference: 16) Mozafar M, Atqiaee K, Haghighatkhah H, et al: Endovenous laser ablation of the great saphenous vein versus high ligation: long-term results. Laser Med Sci 2014; 29: 765–771 – reference: 3) Miyazaki K, Nishibe T, Sata F, et al: Long-term results of treatments for varicose veins due to greater saphenous vein insufficiency. Int Angiol 2005; 24: 282–286 – reference: 7) 田淵篤，正木久男，柚木靖弘，他：大伏在静脈瘤に対する各種術式の治療成績．静脈学2013; 24: 91–99 – reference: 10) 広川雅之，栗原伸久：下肢静脈瘤に対する980 nm レーザーを用いた標準的血管内レーザー治療．日血外会誌2012; 21: 583–588 – reference: 8) Christopoulos DG, Nicolaides AN, Szendro G, et al: Air-plethysmography and the effect of elastic compression on venous hemodynamics of the leg. J Vasc Surg 1987; 5: 148–159 – reference: 4) 田淵篤，正木久男，柚木靖弘，他：下腿部本幹硬化療法を併用した大腿ストリッピング手術の治療成績．静脈学 2011; 22: 11–16 – reference: 20) Pronk P, Gauw SA, Mooij MC, et al: Randomised controlled trial comparing sapheno-femoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anaesthesia: one year results. Eur J Vasc Endovasc Surg 2010; 40: 649–656 – reference: 14) Pannier F, Rabe E: Mid-term results following endovenous laser ablation (EVLA) of saphenous veins with a 980 nm diode laser. Int Angiol 2008; 27: 475–481 – reference: 22) Rasmussen L, Lawaetz M, Bjoern L, et al: 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 2013; 58: 421–426 – reference: 1) Sarin S, Scurr JH, Coleridge Smith PD: Stripping of the long saphenous vein in the treatment of primary varicose veins. Br J Surg 1994; 81: 1455–1458 – reference: 2) Rutgers PH, Kitslaar PJ: Randomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg 1994; 168: 311–315 – reference: 23) Siribumrungwong B, Noorit P, Wilasrusmee C, et al: 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 2012; 44: 214–223 – reference: 12) Desmyttère J, Grard C, Wassmer B, et al: Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients. J Vasc Surg 2007; 46: 1242–1247 – reference: 18) Rasmussen LH, Bjoern L, Lawaetz M, et al: Randomised clinical trial comparing endovenous laser ablation with stripping of the great saphenous vein: clinical outcome and recurrence after 2 years. Eur J Vasc Endovasc Surg 2010; 39: 630–635 – reference: 24) Murad MH, Coto-Yglesias F, Zumaeta-Garcia M, et al: A systematic review and meta-analysis of the treatment of varicose veins. J Vasc Surg 2011; 53 (5 Suppl): 49S–65S |
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| Snippet | 要旨：980-nm ダイオードレーザーによる血管内レーザー治療（EV 群）と大腿ストリッピング（ST 群）の治療成績，静脈機能を比較検討した。両群ともに初期成功率100％で，重... |
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| Title | 血管内レーザー治療の位置づけ—大腿ストリッピング手術との比較検討 |
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