手术后复发性静脉的模式 (REVAS):随机试验的系统审查和网络元分析
Konstantinos Kavallieros1,2, Adam M Gwozdz1, Benedict Turner1
1Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Phlebology
|January 23, 2026
概括
静脉的复发模式因治疗而异. 高绑定手术 (HLS) 显示下骨关节复发,而内静脉方法减少了新血管化. 改进REVAS分类报告对于更好的患者结果至关重要.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 医疗器械技术 医疗器械技术
背景情况:
- 表面静脉不称职的复发在治疗后很常见.
- 手术后复发性静脉瘤 (REVAS) 的分类存在,但治疗方式的复发模式尚不清楚.
研究的目的:
- 基于程序技术,探索静脉的复发模式.
- 为了比较不同治疗方法的复发率,用于原发性沙发静脉缺陷.
主要方法:
- 按照PRISMA指南进行系统审查和随机效应网络元分析.
- 包括手术或静脉内治疗的随机对照试验 (RCT),随访时间≥1年.
- 主要结果:使用REVAS分类来评估反流的复发.
主要成果:
- 对23个RCT的分析显示,根据解剖部分的复发率有所不同:SFJ (23.6%),大腿穿孔器 (7.6%),下腿穿孔器 (4.7%).
- 高结节手术 (HLS) 的SFJ复发风险低于静脉内激光切除 (EVLA) 和泡硬化疗法 (FS).
- EVLA显示穿孔器复发减少与HLS相比;EVLA和FS的新血管化减少与HLS相比. FS具有更高的再通道化风险.
结论:
- 根据治疗方式,复发模式显著不同.
- HLS与较低的SFJ和ASV复发有关,而内静脉方法显示较少的新血管化和大腿穿孔器复发.
- 重要的是,只有13%的RCT使用REVAS进行报告,这阻碍了精确的结果评估和患者护理改进.
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