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Pioneering Patient-Specific Approaches for Precision Surgery Using Imaging and Virtual Reality
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Published on: April 5, 2024

New office-based vascular interventions.

Natalie Marks1, Anil Hingorani, Enrico Ascher

  • 1Maimonides Medical Center, Division of Vascular Surgery, Brooklyn, New York 11219, USA. nmarks@maimonidesmed.org

Perspectives in Vascular Surgery and Endovascular Therapy
|November 22, 2008
PubMed
Summary
This summary is machine-generated.

Office-based vascular procedures, including radiofrequency ablation (RFA) for incompetent perforating veins (IPV) and angioplasty for arteriovenous fistulas (AVF), demonstrate safety and efficacy. These minimally invasive techniques offer effective treatment options for venous insufficiency and fistula management.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Vascular Medicine

Background:

  • Contemporary trends favor performing vascular interventions in an office setting.
  • Incompetent perforating veins (IPV) and failing/non-maturing arteriovenous fistulas (AVF) are common clinical challenges.
  • Minimally invasive endovascular techniques are increasingly utilized for vascular access and venous disease management.

Purpose of the Study:

  • To describe the office-based experience with radiofrequency ablation (RFA) of IPVs.
  • To evaluate duplex-guided balloon angioplasties for failing or non-maturing AVFs performed in an office setting.
  • To assess the safety and efficacy of these endovascular procedures in an outpatient environment.

Main Methods:

  • Radiofrequency ablation (RFA) was performed on 49 incompetent perforating veins (IPVs).
  • Duplex-guided balloon angioplasties were performed on 20 failing or non-maturing arteriovenous fistulas (AVFs) in 18 patients.
  • All procedures, including sheath insertion and device manipulation, were guided solely by duplex ultrasound.

Main Results:

  • Early follow-up confirmed successful occlusion in 92% (45/49) of treated IPVs.
  • Sixty-five percent (13/20) of AVF angioplasties were performed on non-maturing fistulas, while 35% (7/20) were on fistulas in dialyzed patients.
  • No correlation was found between patient demographics, CEAP class, perforator diameter, or GSV patency and procedure failure.

Conclusions:

  • Office-based duplex-guided balloon angioplasties for AVFs and RFA of IPVs can be performed safely.
  • Excellent duplex imaging quality and advancements in endovascular tools facilitate successful outpatient vascular interventions.
  • These minimally invasive office procedures represent effective treatment options for specific vascular conditions.