Comment to: The office based CHIVA, by Passariello F, Ermini S, Cappelli M, Delfrate R, Franceschi C. J Vasc Diagnostics 2013:1:13-20.
Submitted: 28 October 2013
Accepted: 28 October 2013
Published: 20 December 2013
Accepted: 28 October 2013
Abstract Views: 3316
FULL TEXT: 1437
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i) whether the GSV reflux is deviated or not (Shunt I) towards at least one incompetent tributary; and
ii) if the latter is the case, does the GSV trunk reflux disappear while pressing the tributaries with a finger? (positive reflux elimination test [RET]+, Shunt III)
Or not? (negative reflux elimination test [RET]-, Shunt I+II).
For Laser draining crossotomy, the tip of the LASER fiber is placed at the end of the last washing tributary, at a variable and personalized distance from the junction worth SFJ-free cm and one variable and personalized L length segment is treated until the first draining tributary. In the fixed variant of the procedure, starting as described after the last washing vessel, a fixed 7 cm length of the trunk is treated instead. For radio frequency draining crossotomy, the electrode at the tip of the catheter is 7 cm long, though a new available electrode provides a length of 3 cm. Though it is a fixed length procedure, the choice of the smaller electrode could fit a detailed length to be treated. Steam draining crossotomy is at present only a fascinating hypothesis while mechanical draining crossotomy is a good candidate to compete with LASER for its precision. Tributary disconnection can be performed classically by a flush phlebectomy, which is already an ambulatory/office quick procedure. Also, LASER and foam can be used with different effects. Devalvulation of a competent trunk GSV valve, if requested, may be performed during a flush phlebectomy or may be wire guided, using a 18 gauge needle, a wire guide, and a dilatator, generally included in the catheter kit. A follow-up examination will be performed soon after the procedure at 1-week, 1-month, 6 months, 1-year, and 2-years.
Ricci, S. (2013). Comment to: The office based CHIVA, by Passariello F, Ermini S, Cappelli M, Delfrate R, Franceschi C. J Vasc Diagnostics 2013:1:13-20. Veins and Lymphatics, 2(1), 11. https://doi.org/10.4081/ByblioLab.2013.11
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