Ann Surg Treat Res.  2022 Feb;102(2):117-124. 10.4174/astr.2022.102.2.117.

Hydrophilic guidewire usage under ultrasound guidance in facilitating catheter advancement during endovenous treatment of incompetent great saphenous veins

• Hwang K
• Park SW
• Hwang JH
• Kwon YW
• Min J
• Jang H
• Chang IS
• Kim KW

• KMID: 2525449
• DOI: http://doi.org/10.4174/astr.2022.102.2.117

Abstract

Purpose
This study was performed To investigate the use of hydrophilic guidewires for facilitating catheter advancement during varicose vein treatment using radiofrequency ablation (RFA) or cyanoacrylate closure (CAC).
Methods
From March 2016 to April 2019, 463 limbs of 285 with incompetent great saphenous veins were subjected to RFA (321 limbs of 197 patients) or CAC (142 limbs of 88 patients). Procedure records were reviewed for the use of a hydrophilic guidewire, reason for the guidewire usage, and diameter of the guidewire.
Results
A hydrophilic guidewire was used to facilitate catheter advancement to treat 92 of 463 limbs (19.9%). For RFA, a guidewire was used to treat 53 of 321 limbs (16.5%). Among them, 15 limbs (28.3%) had vasospasm, and 38 limbs (71.7%) had venous tortuosity. For CAC, guidewire was used for 39 of 142 limbs (27.5%). Among them, 10 limbs (25.6%) had vasospasm, 23 limbs (59.0%) had venous tortuosity, and 6 limbs (15.4%) had repeated engagement of a J-tip guidewire into the varicose tributaries. In CAC, the frequency of hydrophilic guidewire usage was higher than that in RFA (P = 0.006). All varicose vein treatment sessions were technically successful.
Conclusion
Hydrophilic guidewire usage could facilitate catheter advancement when hindered by vasospasm, tortuosity of the saphenous vein, or repeated engagement into the varicose tributaries.

Keyword

Catheter; Saphenous vein; Varicose veins

Figure

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  Fig. 1 Kaplan-Meyer plot of recanalization during follow-up after treatment of incompetent great saphenous vein with either radiofrequency ablation (RFA) or cyanoacrylate closure (CAC).

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  Fig. 2 Reasons and frequency of hydrophilic guidewire usage when performing (A) radiofrequency ablation (RFA) or (B) cyanoacrylate closure (CAC).

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