EFFICIENCY OF PROPHYLACTIC ABLATION OF THE TRIBUTARY VENOUS PATHWAYS DRAINING AROUND THE SAPHENOFEMORAL JUNCTION TO DECREASE THE RATE OF FUTURE VARICOSE VEIN AND SYMPTOMS OCCURENCE

2021 ◽  
Author(s):  
Mustafa Ozer Ulukan ◽  
Atalay Karakaya ◽  
Korhan Erkanli ◽  
Metin Onur Beyaz ◽  
Didem Melis Oztas ◽  
...  
Keyword(s):  
Varicose Vein ◽  
Saphenofemoral Junction

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

Vascular ◽  
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.

Inferior selective crossectomy for great saphenous vein incompetence: Our experience

Vascular ◽  
2020 ◽  
pp. 170853812094725
Author(s):  
Maurizio Pagano ◽  
Giovanna Passaro ◽  
Roberto Flore ◽  
Paolo Tondi
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Duplex Ultrasound ◽  
Venous Disease ◽  
Recurrence Rates ◽  
Saphenofemoral Junction

Objective To describe the mid-term outcome after inferior selective crossectomy in a subset of patients with symptomatic chronic venous disease and both great saphenous vein and suprasaphenic valve incompetence. Methodsː Retrospective analysis of prospectively collected data was conducted. During an eight-year period, 1095 ligations of all saphenofemoral junction inferior tributaries and great saphenous vein stripping were performed in 814 Clinical, Etiology, Anatomy, Pathophysiology C2–C6 patients. Duplex ultrasound follow-up examinations were performed after 30 days, 6 months, and 2 years, and saphenofemoral junction hemodynamic patterns and varicose veins recurrence rates were evaluated. Results Two hundred and twenty patients completed the two-year follow-up period. At the 30-day Duplex ultrasound evaluations, two different hemodynamic patterns were described. Type 1, with physiological drainage of saphenofemoral junction superior tributaries, was observed in 214 patients. Type 2, without flow in saphenofemoral junction superior tributaries, was observed in six patients. Overall varicose vein recurrence rates were 0, 2.3, and 2.7% at the 30-day, 6-month, and 2-year follow-up examinations, respectively. At the two-year follow-up, Type 1 patients showed 0% varicose vein recurrence, while Type 2 patients showed 100%. Conclusionsː Inferior selective crossectomy seems to be a valid and safe option in case of both suprasaphenic valve and great saphenous vein incompetence. Duplex ultrasound evaluation, according to our protocol, allows us to identify two different saphenofemoral junction hemodynamic patterns that could predict varicose vein recurrence at mid-term. An optimal stump washing after inferior selective crossectomy, warranted by patency and large caliber saphenofemoral junction superior tributaries, seems to be the key point in preventing varicose vein recurrence in this context. However, large prospective studies regarding saphenofemoral junction modifications and varicose vein recurrence are needed to confirm these preliminary observations.

Great saphenous varicose vein surgery without saphenofemoral junction disconnection

2010 ◽  
Vol 97 (6) ◽  
pp. 820-825 ◽  
Author(s):  
P. Zamboni ◽  
S. Gianesini ◽  
E. Menegatti ◽  
G. Tacconi ◽  
A. Palazzo ◽  
...  
Keyword(s):  
Varicose Vein ◽  
Varicose Vein Surgery ◽  
Saphenofemoral Junction

scholarly journals Short Term Fate of Great Saphenous Vein after Radiofrequency Ablation for Varicose Veins

2017 ◽  
Vol 13 (3) ◽  
pp. 234-237
Author(s):  
R.M. Karmacharya ◽  
M Devbhandari ◽  
Y.R. Shakya
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Doppler Ultrasonography ◽  
Distal Part ◽  
Great Saphenous Vein ◽  
Short Term ◽  
Vein Type ◽  
Saphenofemoral Junction

Background Radiofrequency ablation of varicose vein have gained popularity compared to conventional surgery due to comparable long term results in addition to definite immediate superiorities. This modality has been started in Nepal since August 2003 and the study on short term fate of ablated vein segment confirms the anatomical benefit in addition to the clinical benefit.Objective To analyze short term fate of segment of great saphenous vein that has been treated by Radiofrequency ablation in terms of occlusion of saphenofemoral junction and absence of recanalisation on Doppler ultrasonography finding done at 3-6 months postoperative period.Method Total 81 cases subjected for radiofrequency ablation of great saphenous vein in thigh segment during August 2013 – September 2014 were followed up in between 3 to 6 months by Doppler ultrasonography. The findings were classified into type 1 to 4 results based on the anatomic closure of saphenofemoral junction and absence of recanalisation on treated segments.Result There were total 81 cases with 54.3% female and 45.7% male patients. Mean short term follow up duration was 4.9 months (S.D. 1.1 months). Great Saphenous Vein was cannulated most frequently in between 5 cm above knee to 5 cm below knee. Mean number of Radio Frequency Ablation (RFA) segments were 6.6 (SD=3.1). There was complete occlusion (Type 1 results) in 51 cases (63.0%). In 24 cases (29.6%) there was competent saphenofemoral junction with partial recanalisation in distal part of Great Saphenous Vein (GSV) (Type 2 results). In six cases (7.4%) there was incompetent saphenofemoral junction with partial recanalisation in distal part of Great Saphenous Vein (Type 3 results). There were no cases with incompetent saphenofemoral junction with complete recanalisation in distal part of Great Saphenous Vein (Type 4 results).Conclusion Radio Frequency Ablation for varicose vein, besides making clinical improvements, is also associated with good anatomical results.

Tourniquet Use Improves Varicose Vein Stripping

2008 ◽  
Vol 39 (2) ◽  
pp. 52
Author(s):  
PATRICE WENDLING
Keyword(s):  
Varicose Vein

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

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