The specialists at AVC are trained in the full-range of treatment options of varicose vein treatment. These include surgery, radiofrequency ablation, laser, sclerotherapy, and Venaseal, or glue treatment. The recent analysis of the VenaSeal closure procedure shows up to 98.9% success (VeClose study), with fewer complications than laser treatment or surgery. VenaSeal has been trialed in the United States and Europe over the last 5 years. Results published show a low risk of complications and excellent medium-term results. The VeClose study out of Germany, showed a 98.9% closure rate at 6 months. VenaSeal is considered as effective as endovenous laser or radiofrequency ablation but does not involve the use of heat and can therefore be performed with the application of a small amount of local anaesthetic as opposed to a nerve block or large volumes of tumescent anaesthetic. Stockings are usually not necessary and patients are able to return to normal activities immediately. These newer interventions can increase the range of treatment options available to discuss with patients that do not wish to attend a hospital or do not wish to use Private Insurance for the treatment.
A landmark publication of the EVRA study in the New England Journal of Medicine by Dr Gohel has shown that patients with leg ulcers as a result of Varicose Veins can have their treatment improved to heal their ulcers and prevent recurrence by having early endovenous treatment.
In contrast with an earlier study that showed no benefit in early venous treatment by conventional Surgery, this EVRA study has shown that early endovenous ablation of superficial venous reflux resulted in faster healing of venous leg ulcers and more time free from ulcers than deferred endovenous ablation.
This finding has helped clarify the role of venous treatment for this complex group of patients to help improve quality of life.
AVC offers a comprehensive range of endovenous treatments and we encourage patients with leg ulcers to seek an opinion to see if they can gain improvement with this.
Avoiding complications in Vascular Surgery is critical to improving patient outcomes.
The recovery from Endovascular procedures is significantly improved by avoiding access site complications. Dr Phil Puckridge, Director of AVC, has previously performed work on improving access site complications using an Ultrasound Guided Vessel Closure technique, published in the European Journal of Vascular and Endovascular Surgery. This has reduced the risk of complications by 50%, helping improve patient outcomes from endovascular treatment.
Dr Puckridge noted that the use of Vessel Closure Devices are superior to manual compression, reduces time to haemostasis, facilitates patient mobilisation and decreases length of stay, but does not reduce complications. Through this study, and adopting this technique, complication rates are also now reduced.
Dr Conor Marron, of AVC, was invited to provide an Editorial as an overview of an Australian scientific publication in the Australia and New Zealand Journal of Surgery. This article focused on the trends of treatment of arterial disease in Australia between 2001 to 2015.
He comments, “Treatments for peripheral arterial disease (PAD) have changed significantly. The increased utilization of endovascular techniques has been driven by a change in patient demographics, patient demand, an explosion in technology….
Technological advances have contributed to the increase in endo- vascular techniques. The use of occlusion-crossing devices and retrograde vessel access techniques has improved the success rate of treating occlusions that were previously untreatable, either by surgery or endovascular means. The use of vessel preparation technologies, including atherectomy and drug-eluting balloon and stent technology, has the potential to improve the durability of results we are achieving.”
He concludes “Endovascular interventions will continue to increase to meet the challenge of more complex, comorbid patients, making previously untreatable patients treatable, reducing major limb amputation rates and improving mortality of this devastating disease process.”