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An alternative retrograde access puncture for EVLA: a case report

Heart Science Journal · Vol. 6 No. 1 (2025) · hlm. 109–113

DOI
10.21776/ub.hsj.2025.006.01.18
ISSN
2721-9984, 2721-9976
Terbit
2025-01-31
Penerbit
Universitas Brawijaya
Bahasa
en
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: CVI manifests with a variety of clinical symptoms, spanning from varicose veins to venous ulcers, significantly impacting patients' daily lives. While traditional treatments such as compression therapy and surgery remain options, on endovenous laser treatment (EVLT) has emerged as a viable alternative. This article delves into the management of CVI, with a particular focus EVLT as a minimally invasive intervention. Through two case illustrations, it sheds light on the difficulties encountered when accessing the great saphenous vein (GSV) using the conventional antegrade approach, particularly in cases involving obesity and vasospasm. Consequently, a retrograde EVLT technique utilizing proximal GSV access, resulting in successful vein ablation with minimal complications. Overall, this approach presents a promising addition to the management of CVI, offering enhanced patient care and improved outcomes. Case Presentation: Two patients with CVI and challenging antegrade GSV access underwent retrograde EVLT using proximal GSV access. Despite initial difficulties, including obesity and vasospasm, successful vein ablation was achieved with minimal complications. Post-procedural evaluations demonstrated significant symptomatic improvement, highlighting the efficacy of the retrograde technique. Conclusion: Retrograde EVLT utilizing proximal GSV access proves to be a safe and effective alternative in cases where antegrade access is challenging. The technique offers simplicity, minimal complications, and high patient satisfaction, with outcomes comparable to traditional approaches. Extended follow-up studies are needed to confirm the long-term effectiveness of retrograde EVLT compared to antegrade methods. Overall, retrograde EVLT presents a valuable option for managing CVI, particularly in patients with anatomical complexities or vasospasm, contributing to improved patient care and outcomes.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
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Rekan penulisOrganisasiArtikel bersama
Mohammad Saifur RohmanUniversity of Brawijaya22
Cholid Tri TjahjonoUniversity of Brawijaya21
Ardian RizalUniversity of Brawijaya18
Djanggan SargowoUniversity of Brawijaya14
Budi SatrijoUniversity of Brawijaya13
Anna Fuji RahimahUniversity of Brawijaya11
Indra PrasetyaUniversity of Brawijaya9
Heny MartiniUniversity of Brawijaya8
Setyasih AnjarwaniUniversity of Brawijaya8
Seprian WidasmaraUniversity of Brawijaya4
Adhika Prastya WikanandaUniversity of Brawijaya4
Putri Annisa KamilaUniversity of Brawijaya4
Sawitri SatwikajatiUniversity of Brawijaya3
Dyah Ayu IkeningrumRSUD Prof. Dr. Saiful Anwar Malang3
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya3
Evit RuspionoAfiliasi tidak diketahui3
Nikhen NoverikeUniversity of Brawijaya3
Titin Andri WihastutiUniversity of Brawijaya3
Imam Mi'raj SuprayogaUniversity of Brawijaya3
Dea Arie KurniawanUniversity of Brawijaya3
Malombassi Dharmawan Hadiwidjojo HutomoUniversity of Brawijaya3
Yoga WaranugrahaUniversity of Brawijaya2
Tonny AdriyantoUniversity of Brawijaya2
Irma KameliaUniversity of Brawijaya2
Oktafin Srywati PamunaUniversity of Brawijaya2
Zainal FathurohimUniversity of Brawijaya2
Ira Vori NugrohoUniversity of Brawijaya2
Zaki SaidiUniversity of Brawijaya2
Anna Fuji RahimahAfiliasi tidak diketahui2
Dedy IrawanUniversity of Brawijaya2
Muhammad Rizki FadlanUniversity of Brawijaya2
Imelda KrisnasariUniversity of Brawijaya2
Aloysius Yuwono SupraptaUniversity of Brawijaya2
Wella KarolinaUniversity of Brawijaya2
Yoseph Budi UtomoUniversity of Brawijaya1
Ryan RamadhanUniversity of Brawijaya1
Veny KurniawatiUniversity of Brawijaya1

Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.

Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">An alternative retrograde access puncture for EVLA:  a case report</dc:title>
	<dc:creator xml:lang="en">Kurniawan, Catur Rizky</dc:creator>
	<dc:creator xml:lang="en">Kurnianingsih, Novi</dc:creator>
	<dc:creator xml:lang="en">Widito, Sasmojo</dc:creator>
	<dc:subject xml:lang="en">Ablation</dc:subject>
	<dc:subject xml:lang="en">Endovenous Laser Treatment</dc:subject>
	<dc:subject xml:lang="en">Great Savenous Vein</dc:subject>
	<dc:subject xml:lang="en">Retrograde Access</dc:subject>
	<dc:description xml:lang="en">Background: CVI manifests with a variety of clinical symptoms, spanning from varicose veins to venous ulcers, significantly impacting patients' daily lives. While traditional treatments such as compression therapy and surgery remain options, on endovenous laser treatment (EVLT) has emerged as a viable alternative.  This article delves into the management of CVI, with a particular focus EVLT as a minimally invasive intervention. Through two case illustrations, it sheds light on the difficulties encountered when accessing the great saphenous vein (GSV) using the conventional antegrade approach, particularly in cases involving obesity and vasospasm. Consequently, a retrograde EVLT technique utilizing proximal GSV access, resulting in successful vein ablation with minimal complications. Overall, this approach presents a promising addition to the management of CVI, offering enhanced patient care and improved outcomes.
Case Presentation: Two patients with CVI and challenging antegrade GSV access underwent retrograde EVLT using proximal GSV access. Despite initial difficulties, including obesity and vasospasm, successful vein ablation was achieved with minimal complications. Post-procedural evaluations demonstrated significant symptomatic improvement, highlighting the efficacy of the retrograde technique.
Conclusion: Retrograde EVLT utilizing proximal GSV access proves to be a safe and effective alternative in cases where antegrade access is challenging. The technique offers simplicity, minimal complications, and high patient satisfaction, with outcomes comparable to traditional approaches. Extended follow-up studies are needed to confirm the long-term effectiveness of retrograde EVLT compared to antegrade methods. Overall, retrograde EVLT presents a valuable option for managing CVI, particularly in patients with anatomical complexities or vasospasm, contributing to improved patient care and outcomes.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2025-01-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/18330</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2025.006.01.18</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure; 109-113</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2025.006.01</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/18330/478</dc:relation>
	<dc:relation>10.21776/</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2025 Catur Rizky Kurniawan, Novi Kurnianingsih, Sasmojo Widito</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>