Tesis

Hubungan Diameter dan Angka Oklusi Vena Saphena Magna Venous Clinical Severity Score (r-VCSS) Pasca Tindakan Endovenous = Correlation between Diameter and Occlusion Rate of Great Saphenous Vein on Revised Venous Clinical Severity Score (r-VCSS) After Endovenous Laser Ablation (EVLA) in Chronic Venous Insufficiency Patient.

Latar Belakang : Efektifitas Endovenous Laser Ablation (EVLA) terhadap diameter vena saphena magna yang besar masih banyak diperdebatkan, karena diameter vena saphena magna yang besar memiliki angka oklusi yang lebih rendah pasca EVLA dan diperkirakan mempengaruhi nilai revised Venous Clinical Score (r-VCSS). Tujuan dari studi ini adalah untuk meneliti hubungan diameter dan angka oklusi vena saphena magna terhadap rVCSS pasca tindakan EVLA. Metode : Studi potong lintang pasien insufiensi vena kronik pada vena saphena magna yang lakukan EVLA di Rumah Sakit Cipto Mangunkusumo dan rumah sakit jejaring pendidikan subspesialis bedah vaskular dan endovaskular fakultas kedokteran Universitas Indonesia, dari Juli 2023 – Desember 2023. Total didapatkan 37 tungkai dari 34 pasien yang dilakukan EVLA 1470 nm dengan tip radial. Dilakukan pengukuran diameter vena saphena magna dengan usg doppler pada 4 segmen (3 femoral, 1 kruris) dan dibagi berdasarkan nilai potong, dan juga dilakukan penilaian r-VCSS pre EVLA. 1 minggu pasca EVLA dilakukan penilaian oklusi dari vena saphena magna dengan usg doppler dan nilai r-VCSS. Analisis data menggunakan SPSS versi 25.0 secara bivariat dan multivariat. Hasil : Sebanyak 5 tungkai (13,5%) mengalami gagal oklusi 1 minggu pasca EVLA. 5 tungkai dengan gagal oklusi, mengalami kegagalan oklusi pada segmen 1/3 proksimal femoral, yang memiliki diameter > 10 mm (P < 0,05). Tidak ada perbedaan bermakna antara angka oklusi dengan nilai r-VCSS baik pre dan post EVLA (P=0,490 dan P=0,102). Perbedaan diameter sesuai nilai potong tidak mempengaruhi nilai r-VCSS post tindakan. Kesimpulan : Diameter vena pre-EVLA mempengaruhi keberhasilan oklusi pascaEVLA dan dapat digunakan untuk memprediksi terjadinya rekanalisasi. Angka oklusi vena saphena magna tidak mempengaruhi nilai r-VCSS pasca EVLA.
Kata kunci : Endovenous Laser Ablation (EVLA),Diameter, Angka oklusi, r-VCSS


Background : The effectiveness of endovenous laser ablation (EVLA) on large saphenous vein diameter is still widely debated because large saphenous vein diameter has a lower occlusion rate after EVLA and is thought to affect the revised Venous Clinical Score (r-VCSS) value. This study aimed to examine the relationship between diameter and rate of occlusion of the great saphenous vein on r-VCSS after EVLA. Methods: Cross-sectional study of patients with chronic venous insufficiency in the great saphenous vein who underwent EVLA at Cipto Mangunkusumo Hospital and the vascular and endovascular surgery subspecialty teaching network hospital, Faculty of Medicine, University of Indonesia, from July 2023–December 2023. A total of 37 limbs were obtained from 34 patients who underwent 1470 nm EVLA with a radial tip. The diameter of the great saphenous vein was measured using Doppler ultrasound in 4 segments (3 femoral, 1 cruris) and divided based on the cutoff value, and pre-EVLA r-VCSS was also assessed. 1 week after EVLA, the occlusion of the great saphenous vein was assessed using Doppler ultrasound and r-VCSS values. Data analysis used SPSS version 25.0, bivariate and multivariate. Result : A total of 5 legs (13.5%) experienced occlusion failure 1 week after EVLA. The 5 legs with failed occlusion experienced occlusion failure in the proximal 1/3 of the femoral segment, which had a diameter of > 10 mm (P < 0.05). There was no significant difference between the occlusion rate and the r-VCSS value both pre and post EVLA (P=0.490 and P=0.102). The difference in diameter according to the cut value does not affect the post-action r-VCSS value. Conclusion : Pre-EVLA vein diameter influences the success of post-EVLA occlusion and can be used to predict the occurrence of recanalization. The degree of occlusion of the great saphenous vein does not affect the r-VCSS value after EVLA.
Keyword : Endovenous Laser Ablatio (EVLA), Diameter, Occlusion Rate, r-VCSS