1011 Vol. 11 No モーニングセミナー 共催 : 株式会社メディコスヒラタ /Cook Japan 株式会社 1. 肺血栓塞栓症 (PTE) 山田典一 2. 慢性血栓塞栓性肺高血圧症 (CTEPH) 松原広己 / CTEPH CTEPH CTEPH BPA: balloon
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1 1011 Vol. 11 No モーニングセミナー 共催 : 株式会社メディコスヒラタ /Cook Japan 株式会社 1. 肺血栓塞栓症 (PTE) 山田典一 2. 慢性血栓塞栓性肺高血圧症 (CTEPH) 松原広己 / CTEPHCTEPH CTEPH BPA: balloon pulmonary angioplasty BPA 110 BPA
2 202 Invited Lecture 2 Evaluation of venous reflux and obstruction with duplex ultrasound Nicos Labropoulos Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA Venous disease is very prevalent affecting a large number of people in the world. Many patients with venous disease present with sign and symptoms such as pain, swelling, itching, burning sensation, heaviness, skin discoloration, ulcers and venous claudication. A careful history and physical examination should be performed prior to any imaging evaluation in order to identify all the pertinent components that will be important into guiding treatment. For example a patient who presents with varicose veins but had a previous episode of deep vein thrombosis will alter the management. Depending on the extent and severity of deep vein disease the treating physician may lower the expectations of the patients when the varicose veins are treated. Furthermore, prophylaxis may be given during treatment and the use elastic compression stockings may continue after the procedure. Duplex ultrasound DU is the method of choice for detecting acute deep vein thrombosis, reflux and also assess chronic venous obstruction although for the latter there is no a great test to evaluate its impact on the patient. Acute vein thrombosis is detected in supine position and reflux in the standing position. All veins below the inguinal ligament common femoral to the distal calf veins are imaged on B-mode using also compression by the transducer and flow augmentation using color mode and pulsed wave Doppler. In cases where thrombus extends beyond the inguinal ligament, there is reduced or lack of flow phasicity or asymmetric flow signals compared to contralateral side the iliac veins and inferior vena cava are imaged. DU is also very good in detecting recurrent vein thrombosis and following the propagation of superficial and calf vein thrombosis. It can differentiate acute from chronic disease and delineate extrinsic compression. DU is the best method to evaluate reflux. It determines the distribution and extent of reflux and provides a venous map to plan treatment. Saphenous veins, their tributaries, nonsaphenous veins, perforators and all deep veins are examined. It assesses the severity of reflux in individual vein segments by measuring the vein diameter, peak vein velocity and reflux duration. DU offers very good differential diagnosis which is very important to explain the patients signs and symptoms and aid the management. However, it cannot assess the overall impact of reflux and obstruction in the affected limb or evaluate the efficiency of the calf muscle pump. For this plethysmographic measurements are used. Air-plethysmography is the most established technique through which the amount of reflux, severity of obstruction and efficiency of calf muscle pump are assessed.
3 1011 Vol. 11 No 教育講演 2 Klippel-Trenaunay 症候群 太田 敬 1900 Klippel Trenaunay Klippel-Trenaunay KTS 1 nevus varicose veins 1001 KTS KTS ; KTS 1 Kasabach-Merritt Syndrome 1. Klippel M, Trénaunay P: Du naevus variqueux ostéohypertrophique. Archives générales de medicine. 1900: Klippel-Trenaunay Survey V. 1001; 11(1): -.
4 204 ランチョンセミナー 4 共催 : 株式会社インテグラル 1. Use of duplex ultrasound in guiding venous procedures and assessing their outcome Nicos Labropoulos Department of Surgery, Stony Brook University Medical Center, Brook, NY, USA Management of chronic venous disease (CVD) is based on accurate diagnosis in order to define the distribution, extent and type of pathology associated with the patients clinical presentation. Duplex ultrasound (DU) is the method of choice for diagnosing CVD but also to guide treatment and follow-up the results of the different procedures. Using DU guidance percutaneous techniques for vein therapy are possible and thus can be done in an office setting that requires simpler set-up and expenses and at the same time offer better patient convenience. Obtaining access DU is important in obtaining vein access. This is essential for all venous procedures that will be discussed below. The ideal location, depth and suitability of the vein are determined. In this way, the correct vessel is cannulated with fewer attempts and without injuring adjacent structures. Sclerotherapy Both liquid and foam sclerotherapy are performed for veins with DU guidance exception being the injections for spider and reticular veins that are directly visible in the skin. The foam is easily traced through the refluxing veins and additional injections are performed in unaffected vein segments. With direct DU imaging arterial injections that can be damaging locally are avoided. Sclerotherapy is used as a sole treatment or as an adjunct to other methods of therapy. In cases with venous malformations and neovascularization DU-guided sclerotherapy is the main mode of treatment. Endovenous thermal and mechano-chemical ablation DU is essential for placing the catheter at the appropriate distance from junctions. It is used to perform the tumescence anesthesia for the endothermal techniques with Laser and Radiofrequency. The saphenous veins and their accessory veins are selected for treatment based on their diameter, duration of reflux, distance from the skin, presence of tortuosity and luminal obstruction. The effect of treatment is assessed directly during the procedure. Thrombolysis DU is used mostly for access in order to perform catheter directed or pharmacomechanical thrombolysis through direct venographic imaging. The advantage of using DU is that thrombosed veins can be accessed. Furthermore, areas with chronic obstruction and extrinsic compression can be identified prior to the treatment. The effect of thrombolysis can be assessed during treatment before the removal of the catheters. In patients with remaining obstruction intravascular ultrasound (IVUS) may be used to determine the severity of pathology and allow accurate placement (sizing and length) of stents. Treatment of chronic venous obstruction Here the DU is used for access, determine the adequacy of the inflow, demonstrate collateral pathways and assess the type of the obstruction (intraluminal, extrinsic compression or both). The treatment itself is performed under direct venographic imaging which is selectively aided by IVUS as mentioned above. Follow-up DU is a very good method to assess to immediate and long term effects of different venous therapies. The effect of vein ligation and stripping, venous bypass and all the treatments mentioned above can be evaluated. More specifically, residual, recurrent and development of new disease can be assessed. The type of remaining or new pathology can be clearly determined such as finding recanalized ablated veins, neovascularization, new varicose veins, rethrombosis and instent stenosis. Thrombotic complications, hematoma and nerve compression can be identified so appropriate treatment can be given.
5 1011 Vol. 11 No ランチョンセミナー 4 共催 : 株式会社インテグラル 2. 下肢静脈瘤治療の将来に対する展望 小川智弘
6 206 ランチョンセミナー 5 共催 : テルモ ビーエスエヌ株式会社 1. DVT 予防医療機器による合併症 ( 皮膚障害 ) とその対策 実践的対応について 木下幸子 DVT DVT DVT 下肢静脈瘤における弾性着衣の役割 春田直樹 ELVeS
7 1011 Vol. 11 No ランチョンセミナー 6 共催 : 大塚製薬株式会社 PAD に対する治療 最前線と今後 横井宏佳 Sufficient Treatment Of Peripheral Intervention by Cilostazol STOP-IC PAD PAD PAD TASC II Iida O et al. J Vasc Surge. 1008; 18: -9 Soga Y et al. J Am Coll Cardiol. 1009; 11: STOP-IC STOP-IC Rutherford C NC C 100mg/ 100mg/ 100mg/ NC 100mg/ 100mg/ C 100mg/ 100mg/ NC 100mg/ Duplex C NC C 91 NC Duplex peak systolic velocity ratio [PSVR] target lesion revascularization TLR 1 intention-to-treat ITT C 11 NC 18 C 11 per protocol PP C 11 NC 19 C 11 ITT PP ITT C 19 NC 11 P PP 11 TLR C 11 NC 11 C P 0.001
8 208 S3-1 Deep Vein Thrombosis DVT Systemic Thrombolysis ST Catheter Directed Thrombolysis CDT ST CDT 1 1 DVT ST CDT 1 1 /kg Venographic severity score venous filling index VFI CDT 1 11 CDT vs p ST 1 CDT ST CDT ST VFI ml/ sec vs ml/sec, p 1.11 CDT ST S3-2 Xa DVT Xa DVT D-dimer 11μg ml DVT Dalteparin 1U D Enoxaparin 1U 1 E Xa Fondaparinux 1.1mg F Xa Edoxaban Edo 11 11mg Edoxaban 11mg Edo 11 D F 11 E 11 Edo Edo DVT D F E Edo Edo F Edo 11 E D Edo11 DVT D 1 Edo11 major thrombus PTE F 1 1 F 11 E 1 Xa Edoxaban 11mg Fondaparinux Edoxaban 11mg DVT
9 1 Vol. 11 No S3-3 S3-4 VTE VTE VTE VTE11 VTE11 1 VTE DVT major bleeding minor bleeding VTE CV p VTE11 VTE11 VTE VTE VTE VTE VTE Major bleeding 1 VTE VTE11 DVT 1 VTE IVC 1 VTE 1 CV VTE VTE DVT DVT PE 1 DVT 1 CDT VCF1 CDT 11 p 1.11 CDT CDT VCF VCF major PE 11 1 DVT CDT VCF PE
10 210 S3-5 S3-6 VTE 1 VTE VTE VTE , , , , IPC VTE11 IVC 11 microcatheter Massive VTE ADL VTE VTE,VTE 1 VTE 1 11 VTE VTE VTE VTE VTE VTE VTE VTE /, /1 VTE / VTE / VTE 11.1/11.1/11.1 BMI11.1/ 11.1/11.1// ml 1/1/ ml // VTE 11 / /1.11 VTE 1.11 / 1.11 BMI VTE / 1.11 /1.11 VTE 1.11 / 1.11 VTE VTE VTE VTE VTE VTE
11 1 Vol. 11 No S DVT DVT DVT 11 1 DVT / CT / / / DVT DVT S3-8 VTE VTE QOL Xa 1 1 VTE VTE DVT 1 VTE 1 1 MDCT 1 11 VTE / D- VTE QOL
12 212 TA-1 DVT D TA-2 DVT DVT DVT D- 11 DVT D DVT DVT D-1 μg/ml DVT DVT 1.1 μg/ml 1.1 μg/ml p 1.11 DVT 1.1μg/ml DVT DVT DVT D shock index IVCf PCPS PCPS 1 11 IVCf PCPS acute on chronic PCPS
13 TA-3 TA-4 1 Vol. 11 No avulsion SFJ 11mm TLA SFJ LEED mm POD EVLA TRT PD 1 PD 1nm Nd YAG 1 PD Duplex DUS 11W 11Hz/ W 11W 11W 11Hz/W 11W 11W 11Hz/W 11W PD μsec round 11 DUS 1 LIB PP 11W μsec LIB 1 11W PP 1 1W 11W μsec W 11W μsec W 11W μsec 1W 11W μsec 1W 11W μsec 1W 11W μsec 1W 11W PP1W PD 11W μsec PP 1W TRT PD PD PP 1W LIB
14 214 TA-5 TA persistent sciatic artery PSA PSA persistent sciatic vein PSV 1 PSA web CT PSA PSA PSV 1 11 PSA PSV sciatic arcade SA deep femoral vein DFV femoral vein FVSA DFV SA SA PSV 1 PSV PSA PSV 1 1 ELVeS EVLT 1 1 EVLT 11 1 EVLT 1 TLA mm EVLT GSV SSV 11.1 Technical success GSV 11.1 SSV cut down EVLT GSV EVLT EHIT class1 EVLT EVLT
15 1 Vol. 11 No S4-1 S Antheor 1, Neuhaus Protect 1 11 Gunther 1, ALN 11 1 Green Field 1 11 ALN Antheor Trap Ease 1 retrospective 1 IR SR OptEase OE /TrapEase TE IR Gunther Tulip GT 11 OE/TE 11 ALN 11 SR GT 11 OE/TE 11 GT11.1 OE11.1 ALN11.1 CT IR GT11.1 OE/TE 11.1 ALN 11.1 SR GT 11.1 OE/TE 11.1 SR OE/TE p.11 IR GT 1.1 OE/TE 11.1 ALN 1 OE/TE p.11 PE IR GT 1.1 OE/TE 1.1 ALN 1 SR GT 11.1 OE/TE 1 DVT SR GT 11.1 OE/TR 11.1 IR GT 11.1 OE/TR 11.1 ALN 11.1 SR OE/ TR p.11 SR GT1 DVT OE/TE
16 216 S4-3 S4-4 IVCf 1 ALN filter 1 1 VTE IVC filter 11.1 IVCf 1 ALN filter VTE filter 1 VTE 11 IVCf ALN filter ape DVT IVCf DVT 1 DVT ALN filter 1 PCPS ALN filter filter DVT CDT filter.1 ALN filter ape CDT DVT PTE DVT PTE filter 1 PTE 1 IVC DVT 1 11 IVC filter DVT PTE temporary filter 11 retrievable type 1 permanent filter temporary filter retrievable type 1 1 filter IVC filter filter PTE filter 1 1 IVC IVC filter filter PTE filter 1 filter 1 retrievable type1 PTE DVT filter PTE
17 S4-5 VS-1 1 Vol. 11 No Vein Viewer Flex CDT evidence IVC IVC IVC PE DD PE IVC IVC DVT IVC IVC IVC IVC Guenter Tulip IVC 1 IVC IVC IVC CT 1 DVT DVT DVT IVC Vein Viewer Flex 11 cm mm mm 11 Vein Viewer Vision 11G Foam 1.1 polidocanol 1.1 ml room air 1.1 ml 1 ml 11 mm
18 218 VS-2 navigation surgery VS-3 variasion ICG ICG ICG navigasion surgery EVL ICG saphenous conmpartment TLA EVLA SFJ saphenous compartment 1mm 1.inch 1 1mm 1 M1 M1 1 SFJ saphenous compartment JMS 1 1
19 VS-4 Sheath Through Stripper VS-5 1 Vol. 11 No GSV Endovenous laser ablation EVLA - TLA Sheath Through Stripper STS TLA 1mm 1 1 STS EVLA cm EVLA 11.1cm LEED.1J/cm GSV cut down Rod SFJ 1cm 1 TLA GSV ml GSV GSV 1 GSV SFJ 1cm TLA GSV 11ml TLA Diotech Venocure 1 nm watt GSV EHIT 1 11
20 220 VS-6 Interventional Therapy 1 VS vascular access trouble 1 IVR CT cm 11 / 11 IVR 11 11mmHg 1mm, 11mm 11 11mmHg 1 1cm mmhg C S1, 11mmPEIT TACE S1 Child-Pugh C 11 MELD score mm V1 1mm 1mm 1 11mm 1mm 1 V1 1cm V1 conduit 1-1 PRONOVA 1-1 PRONOVA 1 V1 conduit 1-1 PRONOVA 11
21 EL4-1 EL4-2 1 Vol. 11 No mmHg 11 11mmHg VFI venous filling index VFI TLA PIN stab avulsion VFI ml/sec VFI VFI 1.1 P 1.1 VFI 1 VFI VFI- VFI p mmHg 11 11mmHg VFI VFI VFI 11 11mmHg 1 t/ m, 1t/m, 1t/m cm 1 1 cm
22 222 EL4-3 EL elastic stockings ES ES BMI ES COVIDIEN T E D AMI1-SB 1cm Y cm 1mm Student t SPSS Ver1 IBM mmHg mmHg mmHg mmHg ES static stiffness index mmHg mmHg p 1.11 p 1. static stiffness index 11mmHg ES ES ES VTE ES a e 1 VTE ES AMI1-SB 1cm Y B B1 C 1 1 Y mmHg B mmHg B mmHg C mmHg B a 11.1mmHg 1.1mmHg ES 11-11mmHg mmHg Y 1 ES B1 C B VTE
23 1 Vol. 11 No EL4-5 EL , , stiffness 11 B1 11mmHg mmHg 1 11mmHg static stiffness index SSI SSI stiffness SSI 1 B1 RP 11 SSI RP 11mmHg 1 RP SSI SSI 11mmHg SSI 11mmHg RP 11mmHg, SSI 11mmHg 1
24 224 EL EL ,1 1,1 1,1 1, ,1 1,1 1,1 1, DD DD DD sapheno-femoral junction kg ES ES ES 1 1 DD ES
25 1 Vol. 11 No EL4-9 EL cm, cm p SS 1 1 CS 1 1 LS 1 SS LS 1 1 SS
26 226 EL4-11 GLO10-1 CVT CVT maegawa follow up CVT follow up
27 1 Vol. 11 No GLO LT Y11 AMI1-SB B B1 C T static stiffness index APG1 ACI medical ABI BP-RPEIII PAD1 VASAMED B1 C mmhg 11-11mmHg ABI SPP Ejection volume Ankle brachial index skin perfusion pressure GLO
28 228 GLO GLO US CT IVC CT cm IVC MRI 11 mmhg IVC 1 IVC Optease IVC
29 1 Vol. 11 No GLO11-2 Budd Chiari IVR GLO Budd Chiari Palmatz stent 1mm Palmatz stent 1mm side by side stent in stent ELLUMINEX 11mm 11 stent in stent stent IVUS Stanford B 1 IVC IVC IVC 1 IVC 1 1 IVC DD 1.1x1.1cm 1.1g 1ml IVC 1 1.1x1.1cm 1.1.g 1ml IVC PTCBD 1ml IVC
30 230 GLO GLO PLSVC VACTER ASD VSD PDA PS PLSVC PLSVC PLSVC SpO1 11 PLSVC PLSVC NIRO PLSVC NIRO 11mmHg 11mmHg PLSVC PLSVC NIRO PLSVC NIRO 11mmHg 11mmHg SpO PLSVC 1 NIRO seroma e-ptfe / polyeurethane e-ptfe U-Loop seroma 11cm seroma 1 1 seroma 11 seroma polyeurethane
31 1 Vol. 11 No GLO GLO mm mm 11mm CT TCC TCC 1 1 TCC TCC 1 11 TCC TCC TCC 1 TCC 1 TCC TCC 1 TCC TCC TCC bridge use
32 232 GLO13-1 DVT 1 GLO MRI Babinski 1 CT PE CT CT MMT 1 MRI high lesion DVT PE CT NSAIDs NSAIDs 1 NSAIDs
33 1 Vol. 11 No GLO13-3 GLO13-4 FPX unfractionated heparin UFH antithrombin AT 1 heparin - induced thrombocytopenia HIT FPX PE DVT DVT 11 FPX x/μl x/μl p FPX HIT BMI HIT FPX HIT HIT FPX HIT FPX HIT 11 1 FDP 11.1 D 11.1 S 11.1 CT IVC IVC 1 11 CT 11 11
34 234 GLO GLO14-2 VTE IVCF VTE IVCF DVT cm 11 cm 1 11 cm CT 1 DVT PE 1 1 fondaparinux 1 IVCF IVCF 1 IVCF VTE DVT PE 1 IVCF IVCF D- 1.1μg/ ml / 1 CT 11 OptEase 11 / CT IVC / 1 IVC IVC 1 IVC 11
35 1 Vol. 11 No GLO GLO14-4 Gunther Tulip Stanford B Gunther Tulip DVT CT DD DD 1.1 μg/ml CT 1 CT
36 236 GLO14-5 IVC ALN GLO IVCF 1 IVCF ALN PTE ALN 1 ALN PTE Penetration 1 Migration Tilting Jumping jump 11 11mm 1 11 IVCF IVC 1 IVC IVC Gunther Tulip IVC IVC
37 1 Vol. 11 No GLO GLO15-2 DVT cm 11kg CT DVT DVT 11 Af, AMI 1 1 CT SVC, IVC FV Eustachian valve IVC filter 11 DVT
38 238 GLO NTT GLO , CT TLA PA m 11/11 11 mmhg CO/CI 1.11/1.11 PVR dyn DVT CT S PCPS 11 PCPS 11 band webs PTE
39 1 Vol. 11 No GLO15-5 CTEPH GLO16-1 Dual-energy CT lung PBV CTEPH mmHg PVR mmHg PVR 1POD 11POD 11mmHg 11mmHg CTEPH 1 Dual-energy CT lung perfused blood volume imaging lung PBV HU PTE CT pulmonary angiography PTE Dual-energy imaging Siemens SOMATOM Definition kv/11kv 1 lung PBV workstation Syngo MultiModality, Siemens Healthcare Hounsfield Unit HU mean lung PBV CT RV LV RV/LV mean lung PBV mean lung PBV HU HU HU 1 PTE RV/LV mean lung PBVs -1. p 1.1 Lung PBV HU PTE
40 240 GLO16-2 1D-CT GLO ,1 1, gold standard DSA 1D-CT MDCT AZE Virtual Place Advance 1D CT 1D Fig.1 Fig.1 1D-CT gold standard VTE VTE PTE PTE non-massive 11 sub-massive 11 massive 11 CPA 1 DVT PTE 1 1 PCPS 1 1 PTE PCPS PTE 1 PTE VTE
41 1 Vol. 11 No GLO GLO17-1 nmcw EVLA FPX Xa APTT 1 1 venous thromboembolism VTE FPX PESI pulmonary embolism severity index score Massive1 submassive11 PESI score 1 1 FPX FPX Tmax 1 submassive PE FPX Bridge FPX nmcw EVLA EVLA CEAP C1 11 C1a 1 C1b 1 C1 1 C1 1 EVLA ST1 SSV HL1 1 HL stab avulsion 11 HL 1 IPV 11 GSV 11 SSV 1 GSV SSV 1 1 Cutdown 1 conversion 1 11J/cm TLA ml 1 ASV SFJ EHIT 1 I 1 DVT EHIT DVT 1 11/ /1 1 1 Dodd IPV EVLA stab avulsion
42 242 GLO17-2 EVLA 1 GLO17-3 ELVeS nm EVLA EVLA EVLA EVLA EVLA C1 EVLA 11.1 EVLA EVLA cm J/cm EVLA EVLA I-II E-HIT 1.1 EVLA EVLA EVLA EVLA TLA C1 1 C1 11 C1 1 C1 1 GSV11 SSV GSV 11.1 EHIT 1 1 1
43 1 Vol. 11 No GLO GLO17-5 EVLA GSV 1cm EVLA GSV EVLA 11 GSV 1cm A C A C B A 11 B 11 C 11 EVLA1 A class1 EHIT 1 B 1 A 11 B 11 C 11 cut down A B C GSV EVLA C C GSV C EVLA GSV EVLA GSV EVLA 1 ELVeS- TM EVLA EVLA GSV 11 11, GSV TLA 11W 11 /1 Stub avulsion APG BMI C1 11 C DVT EHIT EVLA GSV BMI APG VFI EF RVF EVLA
44 244 GLO18-1 GLO18-2 EVLA endovenous laser ablation TLA TLA 11.1cm EHIT 1 1 SFJ EHIT DVT EVLA endovenous laser ablation EVLA GSV SSV1 CEAP C1 C1 11 C1 11 C1 11 tumescent local anesthesia TLA, 1.1 lidocaine 1nm Nd YAG 1W mm/sec GSV S-Fjunction cm SSV S-Pjunction 1.1cm 11.1 GSV SSV / / EVLA
45 1 Vol. 11 No GLO18-3 Radial 1ring fiber 1nm GLO JR 1 JR 1 JR radial fiber 1nm EVLA radial fiber 1 radial 1ring fiber 1nm EVLA radial 1ring fiber 1nm EVLA CEAP radial 1ring fiber ELVeS Radial 1ring TM, Biolitec AG, Germany TLA 1nm ELVeS PL laser system, Biolitec AG, Germany 1-11W cm 11.1 J/cm Radial 1ring fiber 1 1 radial fiber
46 246 GLO19-1 GLO19-2 endovenous laser ablation EVLA Visual Analogue Scale VAS EVLA GSV TLA 1 1 VAS 1 VAS P VAS 1 VAS P TLA LEED CEAP EVLA 1 1 nm EVLA EVLA ELVeS nm 1W 1 1 1
47 1 Vol. 11 No GLO19-3 GLO19-4 EVLA small volume stab avulsion stab avulsion 11 stab avulsion DPC EVLA GSV GSV GSV bare radial 1ring fiber 1 nm laser W bare fiber nm 1nm radial 1ring fiber nm 1nm bare radial- 1nm sticking 1ring sticking radial 1ring 1nm
48 248 GLO19-5 EVLA GLO EVLA GSV EVLA GSV GSV bare radial 1ring fiber 1 nm laser W bare fiber radial 1ring fiber nm 1nm bare radial 1ring 1nm EVLA EVLA nm EVLA /1 EVLA EVLA 11 GSV C 1,S, E P, A S, P r EVLA SFJ 11mm 11 nm 1W LEED 11 J/ cm GSV 1 GSV GSV GSV EVLA TLA TLA 11 1nm Radial 1ring fiber 11W LEED 11 J/cm 1 1 GSV EVLA EVLA
49 1 Vol. 11 No GLO GLO20-3 EHIT EVLA EVLA echo φ1 φ1mm LEED 11.1J/cm 11.1J/ cm echo echo EVLA 1 LEEDJ/cm LEED11J/ cm EVLA EVLA EVLA Endovenous Laser Ablation EVLA EHIT Endovenous Heart Induced Thrombosis 11 CEAP 1a 1.1mm 1.1mm 1.1mm EVLA ELVeS 11W LEED 11.1J/cm EHIT 1 EHIT class1 1 EHIT class 1 1.1mg/ 1 1 EHIT 1 EHIT
50 250 GLO ,1 1,1 1,1 1,1 1,1 1,1 1,1 1,1 1 GLO20-5 BMI11.1 EVLA GSV EVLA 1W/ nm GSV CEAP 1 GSV EVLA 1 EHIT class 1 1 EHIT SFJ GSV 1 GSV GSV GSV CEAP 1 GSV EVLA 1 GSV 1 GSV EVLA saphenous compartment GSV 11 cm kg kg CT MRI kg
51 1 Vol. 11 No GLO GLO cm CT Cockett cm Boyd WBC CRP DVT CT
52 252 GLO21-3 GLO CT Cockett Boyd Dodd
53 1 Vol. 11 No GLO GLO22-2 QOL CEAP C1 11 KB g/ 1 11 VAS Visual Analogue Scale CEAP VAS mm CO
54 254 GLO22-3 Intense Pulsed Light IPL GLO22-4 1,1 1,1 1,1 1,1 1,1 1,1 1,1 IPL 1 1 IPL IPL 1nm 1 1 IPL nm 1nm 11 IPL QOL 1 CG 1 / 1 11 φ mmHg 11mmHg 11mmHg 1 11cm kg/m 1 11kg/cm N N mmHg 11 11mmHg
55 1 Vol. 11 No GLO SEPS SEPS SEPS
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Table 1 Patients preoperative characteristics Group LA group SR group No. of patients/legs 137/166 441/531 Age(yr), mean (range) 61.5 (23 82) 62.2 (20
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