Late follow-up of a randomized trial of routine duplex imaging before varicose vein surgery

2011 ◽  
Vol 98 (8) ◽  
pp. 1112-1116 ◽  
Author(s):  
L. Blomgren ◽  
G. Johansson ◽  
L. Emanuelsson ◽  
A. Dahlberg-Åkerman ◽  
P. Thermaenius ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Varicose Vein ◽  
Varicose Vein Surgery ◽  
Duplex Imaging

scholarly journals Late Follow-up of a Randomized Trial of Routine Duplex Imaging Before Varicose Vein Surgery

2012 ◽  
Vol 55 (2) ◽  
pp. 615
Author(s):  
L. Blomgren ◽  
G. Johansson ◽  
L. Emanuelsson
Keyword(s):  
Randomized Trial ◽  
Varicose Vein ◽  
Varicose Vein Surgery ◽  
Duplex Imaging

Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽  
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.

Randomized clinical trial of routine preoperative duplex imaging before varicose vein surgery

2005 ◽  
Vol 92 (6) ◽  
pp. 688-694 ◽  
Author(s):  
L. Blomgren ◽  
G. Johansson ◽  
D. Bergqvist
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Varicose Vein ◽  
Varicose Vein Surgery ◽  
Duplex Imaging

The outcome of recurrent varicose vein surgery: the patients' perspective

2005 ◽  
Vol 20 (2) ◽  
pp. 57-59 ◽  
Author(s):  
A G Edwards ◽  
O Donaldson ◽  
C Bennetts ◽  
D C Mitchell
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Varicose Vein Surgery ◽  
Failure Group ◽  
Recurrent Varicose Veins ◽  
Success Group ◽  
The Mean ◽  
Patient’S Perception ◽  
Patients Perspective

Objectives: This study was performed to assess the patient's perception of the outcome of recurrent varicose vein surgery. Methods: Patients who underwent surgery for recurrent varicose veins between 1 January 1995 and 31 December 1998 were sent a questionnaire and Aberdeen Varicose Vein Severity Score (AVVSS) in September 2003. Results: A total of 48 questionnaires were distributed and 40 responses (83%) were received. The mean length of follow-up was 81.78 months. Outcome was 'excellent' (no varicose veins) for four patients, 'satisfactory' for 22 (small, asymptomatic recurrence), 'unsatisfactory' for 10 (symptomatic recurrence) and 'worse' for four patients; 65% thought that the outcome was successful (excellent or satisfactory) and 35% a failure. The median AVVSS in the success group was 11.50 (IQR 7.94–19.69) compared with 29.63 (IQR 18.46–40.31) in the failure group ( P = 0.0009, Wilcoxon). Conclusions: Two-thirds of patients undergoing surgery for recurrent varicose veins are satisfied with the outcome, nearly seven years after surgery. One-third will regard surgery as having failed. Patients should be advised of these potential outcomes prior to surgery.

Evidence-Based Follow-up after Varicose Vein Surgery

2001 ◽  
Vol 16 (4) ◽  
pp. 170-172
Author(s):  
C. M. H. Bailey ◽  
J. M. T. Perkins ◽  
S. Garnett ◽  
G. Libertiny ◽  
H. Umeh ◽  
...  
Keyword(s):  
General Practitioner ◽  
Varicose Vein ◽  
Daily Activities ◽  
Evidence Based ◽  
Varicose Vein Surgery ◽  
Median Length ◽  
Outpatient Consultation ◽  
Postoperative Problems ◽  
Analogue Scales

Objective: To determine the optimum timing and need for outpatient follow-up of patients after varicose vein operations. Methods: Ninety-six consecutive patients undergoing varicose vein operations were enrolled. Patients completed linear analogue scales to record pain, bruising and swelling on postoperative days 1 to 10, 12, 14, 21 and 28. Return to daily activities, visits to the general practitioner (GP) and outpatient review at 6 weeks were recorded. Results: Maximum scores were on day 2 for swelling, day 4 for bruising, and days 1 and 6 for pain. Median time to return to work was 14 days (range 1-42 days). During the postoperative period 29 patients visited their GP, 24 (83%) within 2 weeks of operation. Median length of outpatient consultation at 6 weeks was 5 min. Although 57 patients found the appointment reassuring, none required further treatment. Conclusions: Outpatient follow-up after varicose vein operations cannot be justified on clinical grounds. The majority of patients who have postoperative problems develop them within the first 2 weeks, coinciding with the peaks of pain, swelling and bruising, and these problems can be dealt with in the community.

Recurrence following Varicose Vein Surgery

2002 ◽  
Vol 16 (3) ◽  
pp. 101-105 ◽  
Author(s):  
D. D. I. Wright ◽  
K. G. Rose ◽  
E. Young ◽  
C. N. McCollum
Keyword(s):  
Varicose Vein ◽  
Continuous Wave ◽  
Varicose Veins ◽  
Postal Questionnaire ◽  
Consecutive Series ◽  
Varicose Vein Surgery ◽  
Recurrence Rates ◽  
Primary Surgery ◽  
Mean Time

Objective: To determine the site-specific rates of recurrence following varicose vein surgery. Design: Postal questionnaire followed up by telephone enquiries. Full clinical review, including continuous wave and duplex Doppler investigations were carried out for all patients with responses suggesting recurrence. Setting: Surgicare Manchester, an independent provider of specialist varicose vein treatments. All procedures were guided by Doppler ultrasound and performed by surgeons working to the same protocol. Subjects: A consecutive series of 250 operations on 246 Patients. Of these, 208 (85%) could be contacted for follow-up. Mean time to re-examination was 27 months. Results: Twelve patients returned spontaneously and 51 were recalled for examination based on questionnaire responses. Recurrences were divided into ‘site’, ‘perforator’ or ‘new site’ recurrence. Primary surgery to the sapheno-femoral junction (SFJ) had the lowest ‘site’ recurrence rate of 2.3% compared with 9.5% for SFJ re-operation. Primary surgery and re-operation of the sapheno-popliteal junction (SPJ) had higher recurrence rates of 8.3% and 7.8% respectively. New incompetence was detected in 5% and 2% of previously competent SFJ and SPJ respectively. Minor perforator incompetence was found in a further 14%. Conclusions: Varicose veins were progressive in some individuals, with new sites of incompetence appearing over time. However, ‘cure’ remains possible for most Patients and major recurrence can be reduced by Doppler diagnosis and precise surgery.

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