RESEARCH PAPER
Minimally invasive, endovenous laser treatment of varicose veins in patients with von Willebrand disease
 
More details
Hide details
1
Department of Vascular Surgery and Angiology, Medical University of Lublin, Poland
 
2
Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
 
3
Centre of Plastic Surgery of Maciej Kuczyński, Lublin, Poland
 
 
Ann Agric Environ Med. 2013;20(4):880-883
 
KEYWORDS
ABSTRACT
The presented report presents a minimally invasive approach for the treatment of varicose veins in patients with chronic venous disease and coexisting von Willebrand disease, the most common inherited bleeding disorder. Conventional stripping of an insufficient great saphenous vein and varicose vein surgery, carries a potential risk of serious bleeding complications in this specific group of patients. It is related to the extent of open surgery, significant tissue trauma, and possible post-operative bleeding of wounds. Less aggressive techniques, such as endovenous laser treatment or radiofrequency ablation, gain increasing popularity as a valuable and equally efficient alternative to conventional surgery in patients with varicose veins. Both of these endovenous techniques seem to have special indications in patients with bleeding disorders. Shortening of hospitalization, quick recovery time and return to normal daily activities, optimal cosmetic effect of the procedure, are also advantageous. The paper presents the technique and results of endovenous laser treatment of great saphenous vein insufficiency and varicose veins in a patient with type I von Willebrand disease. Available data on peri-operative care standards, optimization of the safety of procedures, and prevention of bleeding complications in surgical patients with von Willebrand disease, specifically undergoing varicose veins surgery are analysed.
REFERENCES (25)
1.
Rodeghiero F, Castaman G, Dini E. Epidemiological investigation of the prevelance of von Willebrand’s disease. Blood 1987; 69: 454–459.
 
2.
Castaman G, Montgomery RR, Meschengieser SS, Haberichter SL, Woods AI, Lazzari MA. Von Willebrand’s disease diagnosis and laboratory issues. Haemophilia 2010; 16(5): 67–73.
 
3.
Federici A. Prophylaxis of bleeding episodes in patients with von Willebrand disease. Blood Transfus. 2008; 6(2): 26–32.
 
4.
Zdziarska J, Chojnowki K, Klukowska A, Łętowska M, Mital A, PodolakDawidziam M, Windyga J, Zawilska K on behalf of The Working Group of Polish Society of Haematology and Blood Transfusion Medicine. The management of von Willebrand disease. Med Praktyczna 2008; 12: 1–24.
 
5.
Schneppenheim R, Budde U. Treatment of von Willebrand Disease. Von Willebrand Disease and von Willebrand Factor. Current aspects of diagnosis and treatment. UNI-MED Verlag AG Bremen-LondonBoston 2008; 68–73.
 
6.
Nitu-Whalley IC, Griffioen A Harrington Ch, Lee ChA. Retrospective review of the Management of Elective Surgery With Desmopressin and Clotting Factor Concentrates in Patients With von Wilebrand Disease. Am J Hematol. 2001; 66: 280–284.
 
7.
Geier B, Stücker M, Hummel T, Burger P, Frings N, Hartmann M, Stenger D, Schwahn-Schreiber C, Schonath M, Mumme A. Residual stumps associated with inguinal varicose vein recurrences: A multicenter study. Eur J Vasc Endovasc Surg. 2008; 36: 207–210.
 
8.
Lethagen S. Haemostatic treatment in connection with surgery in patients with von Willebradn disease. Haemophilia 1999; 5(2): 64–67.
 
9.
Shah SB, Lawani AK, Koerper MA. Perioperative Management of von Willebrand’s Disease in Otolaryngologic Surgery. The Laryngoscope 1998; 108: 32–36.
 
10.
Federici AB, Castaman G, Thompson A, Berntorp E. Von Willebrand’s disease: clinical management. Haemophilia 2006; 12(3): 152–158.
 
11.
Santoro C, Hsu F, DiMichele DM. Haemostasis prophylaxis using single dose desmopressin acetate and extended use epsilon aminocapronic acid for adenotonsillectomy in patients with type 1 von Willebrand disease. Haemophilia 2012; 18(2): 200–204.
 
12.
Pascheco L, Constantine, Saade G, Mucowski S, Hankins GD, Sciscione AC. Von Willebrand disease and pregnancy: a practical approach for the diagnosis and treatment. Am J Obstet Gynecol. 2010; 203(3): 194–200.
 
13.
Shindel A, Tobin G, Klutke C. Hyponatremia associated with desmopressin for treatment of noctual polyuria. Urology 2002; 60: 344.
 
14.
Lethagen S. Desmopressin (DDAVP) treatment. Hemophilia. Octafarma 2004: 72–76.
 
15.
Mannucci PM. Treatment of von Willebrand’s disease. N Engl J Med. 2004; 351: 683–694.
 
16.
Mannucci S., Ruggeri Z., Pareti F., Capitanio A. A new pharmacological approach to the management of hemophilia and von Willebrand disease. Lancet 1977; 1: 869–872.
 
17.
Federici A, Sacco R, Stabile L, Carpenedo M, Zingaro E, Mannucci PM. Optimizing local therapy during oral surgery in patients with von Willebrand disease: effective results from a retrospective analysis of 63 cases. Haemophilia 2000; 6: 71–77.
 
18.
Leissinger C, Becton D, Cornell C Jr, Cox Gill J. High-dose DDAVP intranasal spray (Stimate) for the prevention and treatment of bleeding in patients with mild haemophilia A, mild o moderate type 1 von Willebrand disease and symptomatic carries of haemophilia A. Haemophilia 2001; 7: 258–66.
 
19.
Bernstein J, Cox Gill J, Leissinger C, Humate P Study Group. Safety and efficacy of von Willebrand factor/factorVIII concentrate (Humate P) for prophylaxis of excessive bleeding elective surgery in patients with von Willebrand disease. Blood 2006; 108 abstract 4076.
 
20.
Federici A, Castaman G, Franchini M, Morfini M, Zanon E, Coppola A, Tagliaferri A, Boeri E, Mazzucconi MG, Rossetti G, Mannucci PM. Clinical use of Haemate P in inherited von Willebrand disease: a cohort study on 100 Italian patients. Haematologica 2007; 92: 944–951.
 
21.
Lethagen S, Kyrle P, Castaman G, Haertel S, Mannucci PM, HAEMATE P Surgical Study Group. Von Willebrand factor/factor VIII concentrate (Haemate P) dosing based on pharmacokinetics: a prospective multicenter trial in elective surgery. J Thromb Haemost. 2007; 5: 1420–1430.
 
22.
Borel-Derlon A, Federici A, Roussel-Robert V, Goudemand J, Lee CA, Scharrer I, Rothschild C, Berntorp E, Henriet C, Tellier Z, Bridey F, Mannucci PM. Treatment of severe von Willebrand disease with a highpurity von Willebrand factor concentrate (Wilfactin): a prospective study of 50 patients. J Throm Haemost. 2007; 5: 1115–1124.
 
23.
Castaman G., Tosetto A., Federici A., Rodeghiero F., Bleeding tendency and efficacy of anti-haemorrhagic treatments in patients with type 1 von Willebrand disease and increased von Willebrand factor clearance. Thromb Haemost. 2011; 105: 647–654.
 
24.
Manucci P. Treatment of von Willebrand disease. N Eng J Med. 2004; 351: 683–694.
 
25.
Federici A. Management of von Willebrand disease with factor VIII/ von Willebrand factor concentrates: results from current studies and surveys. Blood Coagulation and Fibrinolysis 2005; 16: S17-S21.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top