Great saphenous varicose vein surgery without saphenofemoral junction disconnection

Summary Background: Platelet function inhibitors (PFI) are used for prophylaxis of atherothrombosis. These drugs cause a prolongation of the bleeding time and should eventually be stopped before an elective operation. However, there is a risk that a perioperative pause of PFI lead to acute atherothrombosis. Objective: Our aim was to study whether a discontinuation of PFI therapy is necessary to avoid bleeding complications in patients undergoing varicose vein surgery. Methods: Selective review of the literature and retrospective analysis of clinical data of our own patients. Results: In the years 2002 to 2007 a total of 10 827 patients have been operated on varicose veins, 673 (6.2%) of these aged 32–86 years (67 ± 7.9) receiving permanent PFI therapy: 256 male patients (38.0%) and 417 female (62.0%), 39.1% categorized as ASA III patients: male 11.6%, female 27.5%. 38 patients who continued PFI therapy did not demonstrate haemorrhagic complications and none of those pausing anti-platelet medication experienced thromboembolic complications. The literature survey confirmed our finding that it is not necessary to suspend PFI medication for varicose vein surgery as the bleeding risk can be controlled for by technical means. Conclusion: Discontinuation of PFI therapy prior to interventions on varicose veins does not seem to be necessary, further studies are essential though.

Download Full-text

Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽

10.1055/s-0037-1622175 ◽

2007 ◽

Vol 36 (03) ◽

pp. 132-136

Author(s):

M. W. de Haan ◽

J. C. J. M. Veraart ◽

H. A. M. Neumann ◽

P. A. F. A. van Neer

Keyword(s):

Varicose Vein ◽

Varicose Veins ◽

Varicose Vein Surgery ◽

Proximal Point ◽

Perforating Veins ◽

Recurrent Varicose Veins ◽

Below The Knee ◽

Duplex Imaging ◽

Additional Value

SummaryThe objectives of this observational study were to investigate whether varicography has additional value to CFDI in clarifying the nature and source of recurrent varicose veins below the knee after varicose vein surgery and to investigate the possible role of incompetent perforating veins (IPV) in these recurrent varicose veins. Patients, material, methods: 24 limbs (21 patients) were included. All patients were assessed by a preoperative clinical examination and CFDI (colour flow duplex imaging). Re-evaluation (clinical and CFDI) was done two years after surgery and varicography was performed. Primary endpoint of the study was the varicographic pattern of these visible varicose veins. Secondary endpoint was the connection between these varicose veins and incompetent perforating veins. Results: In 18 limbs (75%) the varicose veins were part of a network, in six limbs (25%) the varicose vein appeared to be a solitary vein. In three limbs (12.5%) an incompetent sapheno-femoral junction was found on CFDI and on varicography in the same patients. In 10 limbs (41%) the varicose veins showed a connection with the persistent below knee GSV on varicography. In nine of these 10 limbs CFDI also showed reflux of this below knee GSV. In four limbs (16%) the varicose veins showed a connection with the small saphenous vein (SSV). In three limbs this reflux was dtected with CFDI after surgery. An IPV was found to be the proximal point of the varicose vein in six limbs (25%) and half of these IPV were detected with CFDI as well. Conclusion: Varicography has less value than CFDI in detecting the source of reflux in patients with recurrent varicose veins after surgery, except in a few cases where IPV are suspected to play a role and CFDI is unable to detect these IPV.

Download Full-text

Cellular senescence at the saphenofemoral junction in patients with healthy, primary varicose and recurrent varicose veins – A pilot study

Vascular ◽

10.1177/17085381211012882 ◽

2021 ◽

pp. 170853812110128

Author(s):

Dominic Mühlberger ◽

Anne-Katrin Zumholz ◽

Erich Brenner ◽

Achim Mumme ◽

Markus Stücker ◽

...

Keyword(s):

Pilot Study ◽

Cellular Senescence ◽

Varicose Vein ◽

Varicose Veins ◽

Common Finding ◽

Venous Disease ◽

Venous Reflux ◽

Recurrent Varicose Veins ◽

Primary Varicose Veins ◽

Saphenofemoral Junction

Objectives Cellular senescence could play a role in the development of venous disease. Superficial venous reflux at the saphenofemoral junction is a common finding in patients with primary varicose veins. Furthermore, reflux in this essential area is associated with higher clinical stages of the disease and recurrent varicose veins. Therefore, this pilot study aimed to investigate cellular senescence in the immediate area of the saphenofemoral junction in patients with healthy veins, primary varicose veins and additionally in patients with recurrent varicose veins due to a left venous stump. Methods We analyzed vein specimens of the great saphenous vein immediately at the saphenofemoral junction. Healthy veins were collected from patients who underwent arterial bypass reconstructions. Samples with superficial venous reflux derived from patients who received high ligation and stripping or redo-surgery at the groin, respectively. Sections were stained for p53, p21, and p16 as markers for cellular senescence and Ki67 as a proliferation marker. Results A total of 30 samples were examined (10 healthy, 10 primary varicose, and 10 recurrent varicose veins). We detected 2.10% p53+ nuclei in the healthy vein group, 3.12% in the primary varicose vein group and 1.53% in the recurrent varicose vein group, respectively. These differences were statistically significant ( p = 0.021). In the healthy vein group, we found 0.43% p16+ nuclei. In the primary varicose vein group, we found 0.34% p16+ nuclei, and in the recurrent varicose vein group, we found 0.74% p16+ nuclei. At the p < 0.05 level, the three groups tended to be significant without reaching statistical significance ( p = 0.085). There was no difference in respect of p21 and Ki67. Conclusion We found significantly higher expression rates of p53 in primary varicose veins at the saphenofemoral junction than in healthy veins. p16 expression tended to be increased in the recurrent varicose vein group. These preliminary findings indicate that cellular senescence may have an impact in the development of varicose veins or recurrence. Further studies addressing this issue are necessary.

Download Full-text

MARKING IN VARICOSE VEIN SURGERY

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1961.tb82592.x ◽

1961 ◽

Vol 2 (2) ◽

pp. 74-74

Keyword(s):

Varicose Vein ◽

Varicose Vein Surgery

Download Full-text

Quadratus lumborum block enables complete anesthesia for radiofrequency ablation in varicose vein surgery

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2019.02.009 ◽

2019 ◽

Vol 56 ◽

pp. 151-152 ◽

Cited By ~ 1

Author(s):

Sechol Oh ◽

Woojin Kwon

Keyword(s):

Radiofrequency Ablation ◽

Varicose Vein ◽

Varicose Vein Surgery ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum

Download Full-text

Randomized, blinded study to assess the effect of povidone-iodine on the groin wound of patients undergoing primary varicose vein surgery

ANZ Journal of Surgery ◽

10.1111/ans.12077 ◽

2013 ◽

Vol 83 (11) ◽

pp. 844-846 ◽

Cited By ~ 2

Author(s):

Stuart R. Walker ◽

Anne Smith

Keyword(s):

Varicose Vein ◽

Povidone Iodine ◽

Varicose Vein Surgery ◽

Blinded Study

Download Full-text

The Optimal Duration of Compression Therapy Following Varicose Vein Surgery: A Meta-analysis of Randomized Controlled Trials

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2013.01.030 ◽

2013 ◽

Vol 45 (4) ◽

pp. 397-402 ◽

Cited By ~ 20

Author(s):

T.-W. Huang ◽

S.-L. Chen ◽

C.-H. Bai ◽

C.-H. Wu ◽

K.-W. Tam

Keyword(s):

Randomized Controlled Trials ◽

Varicose Vein ◽

Meta Analysis ◽

Compression Therapy ◽

Controlled Trials ◽

Varicose Vein Surgery ◽

Randomized Controlled ◽

Optimal Duration

Download Full-text

Varicose Veins: optimum compression after surgery and sclerotherapy

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-76-101 ◽

1990 ◽

Vol 76 (2) ◽

pp. 101-104

Author(s):

P. J. Shouler ◽

P. C. Runchman

Keyword(s):

Surgical Treatment ◽

Varicose Vein ◽

Varicose Veins ◽

Compression Stocking ◽

Compression Stockings ◽

Varicose Vein Surgery ◽

High Compression ◽

Graduated Compression Stockings ◽

Non Surgical Treatment

SummaryGraduated compression stockings are used in both surgical and non-surgical treatment of varicose veins. In a trial of high versus low compression stockings (40mmHg vs 15mmHg at ankle) after varicose vein surgery, both were equally effective in controlling bruising and thrombophlebitis, but low compression stockings proved to be more comfortable.In a further trial after sclerotherapy, high compression stockings alone produced comparable results to Elastocrepe® bandages with stockings. It is concluded that after varicose vein surgery low compression stockings provide adequate support for the leg and that after sclerotherapy, bandaging is not required if a high compression stocking is used.

Download Full-text