Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492012000400009
Jornal Vascular Brasileiro
Original Article

Efeitos imediatos do eletrocautério endovascular em varizes de membros inferiores

Immediate effects of endovascular electrocauterization in lower limb varicose veins

Fabio Henrique Rossi; Camila Baumann Beteli; Mabel Barros Zamorano; Lilian Mary da Silva; Patrik Bastos Metzger; Cybelle Bossolani Onofre; Edir Branzoni Leal; Akash Kuzhiparambil Prakasan; João Italo Dias França; Nilo Mitsuru Izukawa; Amanda Rego Souza

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Resumo

OBJETIVOS: Determinar a importância das variáveis: Intensidade de Energia (I), Potência (P) e Tempo de Aplicação (T) nas alterações histológicas ocorridas em varizes de membros inferiores submetidas à eletrocauterização endovascular. MÉTODO: Estudo prospectivo experimental realizado em pacientes submetidos à eletrocauterização endovenosa de fragmento proximal da veia safena magna, de acordo com uma tabela de aleatorização - GI: I=0J, P=0W, T=15s; GII: I=300J, P=60W, T=5s; GIII: I=600J, P=60W, T=10s; GIV: I=900J, P=60W, T=15s; GV: I=450J, P=90W, T=5s; GVI: I=900J, P=90W, T=10s; GVII: I=1350J, P=90W, T=15s; GVIII: I=600J, P=120W, T=5s; GIX: I=1200J, P=120W, T=10s; GX: I=1800J, P=120W, T=15s. Os fragmentos foram submetidos a estudo anatomopatológico com o objetivo de analisar a profundidade das alterações tissulares, assim classificadas: Grupo A - endotélio e média, Grupo B - endotélio, média e adventícia. RESULTADOS: A intensidade das alterações histológicas - Grupo A e B - ocorridas nos fragmentos foram proporcionais à Intensidade de Energia de eletrocauterização (p=0,0001). Essa associação linear também pode ser verificada para as variáveis Potência (p=0,017) e Tempo de Aplicação (p=0,0001). O índice de correlação de Spearman foi maior para variável Tempo de Aplicação: 0,42269 (p=0,002) quando comparada com a variável Potência de Energia: 0,3542 (p=0,005). CONCLUSÃO: O Tempo de Aplicação de Energia é mais importante do que a Potência de Energia utilizada para uma mesma energia de eletrocauterização, na determinação da profundidade dos efeitos histológicos observados na parede das varizes de membros inferiores.

Palavras-chave

varizes, procedimentos endovasculares, ablação por cateter

Abstract

OBJECTIVE: To determine the importance of the variables: Energy Intensity (I), Power (P) and Time of Application (T) in the histological changes occurring in lower limb varicose vein submitted to endovascular electrocauterization. METHOD: Prospective experimental study conducted in patients undergoing great saphenous vein electrocauterization according to a randomization table - GI: I=0J, P=0W, T=15s; GII: I=300J, P=60W, T=5s; GIII: I=600, P=60W, T=10s; GIV: I=900J, P=60W, T=15s; GV: I=450J, P=90W, T=5s; GVI: I=900J, P=90W, T=10s; GVII: I=1350W, P=90W, T=15s; GVIII: I=600, P=120W, T=5s; GIX: I=1200J, P=120W, T=10s; GX: I=1800J, P=120W, T=15s. The fragments were submitted to histopathological examination in order to analyze the depth of tissue changes, classified as follows: Group A - endothelium and media; Group B - endothelium, media and adventitia. RESULTS: The intensity of histological changes - Groups A and B - that occur in the fragments were proportional to Energy Intensity of electrocauterization (p=0.0001), Power (p=0.017) and Time of Application (p=0.0001). The Spearman correlation coefficient was more powerful for the variable Time of Application: 0.42269 (p=0.002) when compared with the variable Power of Energy (P): 0.3542 (p=0.005). CONCLUSION: Time of Application of Energy is a stronger predictor than the Power of Energy in determining the depth of the histological effects observed in the wall of the varicose vein submitted to electrocauterization.

Keywords

varicose veins, endovascular procedures, catheter ablation

References

Meissner MH, Eklof B, Lohr JM, Lurie F, Kistner R, Wakefield TW. Preface: acute and chronic venous disease. Current status and future directions. J Vasc Surg.. 2007;Suppl:1S-3S.

Navarro L, Min RJ, Boné C. Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using an 810 nm diode laser. Dermatol Surg.. 2001;27:117-22.

Proebstle TM, Krummenauer F, Gül D, Knop J. Nonocclusion and early reopening of the great saphenous vein after endovenous laser treatment is fluence dependent. Dermatol Surg.. 2004;30:174-8.

Manfrini S, Gasbarro V, Danielsson G. Endovenous management of saphenous vein reflux. Endovenous Reflux Management Study Group. J Vasc Surg.. 2000;32:330-42.

Goldman MP. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatol Surg.. 2000;26:452-6.

Rautio T, Ohinmaa A, Perälä J. Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. J Vasc Surg.. 2002;35:958-65.

Rossi FH, Izukawa NM, Silva DG. Effects of electrocautery to provoke endovascular thermal injury. Acta Cir Bras. 2011;26:5011-331.

Gloviczki P, Comerota AJ, Dalsing MC. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg.. 2011;53:2S-48S.

Lohr J, Kulwicki A. Radiofrequency ablation: evolution of a treatment. Semin Vasc Surg.. 2010;23:90-100.

Ash JL, Moore CJ. Laser treatment of varicose veins: order out of chaos. Semin Vasc Surg.. 2010;23:101-6.

Araújo M, Velasco FCG. Métodos físicos utilizados para oclusão de varizes dos membros inferiores. J Vasc Bras.. 2006;5:139-46.

Hejhal L, Firt P, Livora D. Endovascular electrocoagulation of superficial varices of leg. Rozhl Chir.. 1959;38:418-25.

Musaev SM. Intravascular electrocoagulation of dilated subcutaneous varicose veins of the lower extremities. Eksp Khir Anesteziol.. 1963;27:36-7.

Politowski M, Zelazny T. Complications and difficulties in electrocoagulation of varices of the lower extremities. Surgery.. 1966;59:932-4.

Watts GT. Endovenous diathermy destruction of internal saphenous. Br Med J.. 1972;4:53.

O'Reilly K. Letter: endovenous diathermy sclerosis as a unit of the armamentarium for the attack on varicose veins. Med J Aust.. 1974;1:900.

Lee RC. Injury by electrical forces: pathophysiology, manifestations and therapy. Curr Probl Surg.. 1977;34:679-758.

Akinlaja J, Sachs F. The breakdown of cell membranes by electrical and mechanical stress. Biophys J.. 1998;75:247-54.

Lee RC, Kolodney MS. Electric injury mechanisms: Electrical breakdown of celular membranes. Plast Reconst Surg.. 1987;80:862-7.

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