scholarly journals Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein

2006 ◽  
Vol 43 (1) ◽  
pp. 81-81.e8 ◽  
Author(s):  
Reinhard Fischer ◽  
James G. Chandler ◽  
Dietmar Stenger ◽  
Milo A. Puhan ◽  
Marianne G. De Maeseneer ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Patient Characteristics ◽  
Reflux Recurrence

Femoral vein valve incompetence as a risk factor for junctional recurrence

2017 ◽  
Vol 33 (3) ◽  
pp. 206-212 ◽  
Author(s):  
Sergio Gianesini ◽  
Savino Occhionorelli ◽  
Erica Menegatti ◽  
Anna Maria Malagoni ◽  
Mirko Tessari ◽  
...  
Keyword(s):  
Risk Factor ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Recurrence Risk ◽  
High Ligation ◽  
Frequent Event ◽  
Operative Assessment ◽  
Reflux Recurrence

Background Recurrent varicose veins occur up to 80% of procedures. The sapheno-femoral junction can be involved in more than 50% of cases. A detailed pathophysiological explanation of the phenomenon is still missing. The aim of the present work is to evaluate the role of femoral vein incompetence as risk factor for sapheno-femoral junction recurrence. Methods Three-hundred-eighty-one patients presenting an incompetent great saphenous vein system and eventually also an incompetent femoral tract (C2-6EpAsdPr) underwent a great saphenous vein high ligation with flush ligation also of the incompetent tributaries along the leg, sparing the saphenous trunk. Pre-operatively, all patients underwent a sonographic evaluation assessing the superficial and deep venous systems, including a detailed analysis of the iliac-femoral vein tract above the sapheno-femoral junction. A retrospective statistical analysis assessed the recurrence risk associated with iliac-femoral vein tract incompetence. Results In a 5.5 ± 1.9 years follow-up, great saphenous vein trunk reflux recurrence was detected in 45/381 (11.8%) cases. The reflux source was found in a reconnected sapheno-femoral stump in 11/45 cases (24.5%), in the pelvic network in 8/45 cases (17.8%), in a neovascularization process in 7/45 (15.5%) and in a newly incompetent great saphenous vein tributary in 19/45 (42.2%). At the pre-operative assessment, iliac-femoral vein tract reflux was present in 7 (26.9%) of the 26 cases who developed a sapheno-femoral junction recurrence and in 25 (7%) of the 355 patients who did not demonstrate sapheno-femoral junction recurrence (odds ratio: 4.8; confidence interval 95%: 1.8–12.6; p < .003). Discussion Despite many technical diagnostic and therapeutic refinements, varicose veins recurrence remains a frequent event. The present investigation points out the association among iliac-femoral vein tract incompetence and sapheno-femoral junction recurrences after high ligation.

Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Hach-Wunderle ◽  
Hach
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Stage Iii ◽  
High Ligation ◽  
Surgical Trauma ◽  
Disease Stages

It is known from current pathophysiology that disease stages I and II of truncal varicosity of the great saphenous vein do not cause changes in venous pressure on dynamic phlebodynamometry. This is possibly also the case for mild cases of the disease in stage III. In pronounced cases of stage III and all cases of stage IV, however, venous hypertension occurs which triggers the symptoms of secondary deep venous insufficiency and all the complications of chronic venous insufficiency. From these facts the therapeutic consequence is inferred that in stages I and II and perhaps also in very mild cases of stage III disease, it is enough "merely" to remove varicose veins without expecting there to be any other serious complications in the patient’s further life caused by the varicosity. Recurrence rates are not included in this analysis. In marked cases of disease stages III and IV of the great saphenous vein, however, secondary deep venous insufficiency is to be expected sooner or later. The classical operation with saphenofemoral high ligation ("crossectomy") and stripping strictly adheres to the recognized pathophysiologic principles. It also takes into account in the greatest detail aspects of minimally invasive surgery and esthetics. In the past few years, developments have been advanced to further minimize surgical trauma and to replace the stripping maneuver using occlusion of the trunk vein which is left in place. Obliteration of the vessel is subsequently performed via transmission of energy through an inserted catheter. This includes the techniques of radiofrequency ablation and endovenous laser treatment. High ligation is not performed as a matter of principle. In a similar way, sclerotherapy using microfoam is minimally invasive in character. All these procedures may be indicated for disease stages I and II, and with reservations also in mild forms of stage III disease. Perhaps high ligation previously constituted overtreatment in some cases. Targeted studies are still needed to prove whether secondary deep venous insufficiency can be avoided in advanced stages of varicose vein disease without high ligation and thus without exclusion of the whole recirculation circuit.

Malignant tumours as a rare cause of recurrent thrombophlebitis of the great saphenous vein

Phlebologie ◽  
2008 ◽  
Vol 37 (06) ◽  
pp. 297-300
Author(s):  
N. König ◽  
H. J. Stark ◽  
P.-M. Baier
Keyword(s):  
Differential Diagnosis ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Case Reports ◽  
Malignant Tumours ◽  
Nerve Sheath Tumour ◽  
Below The Knee ◽  
Nerve Sheath ◽  
Unfavourable Prognosis ◽  
Peripheral Nerve Sheath Tumour

SummaryWe present two case reports concerning patients who had to undergone surgical treatment according tp the diagnosis of thrombophlebitis with insufficiency of the greater saphenous vein and putative encapsulated haematoma in the lower left leg area. During the operation we found tumours with urgent suspicion of malignancy. The histological examination revealed the diagnosis of mesenchymal chondrosarcoma and malignant peripheral nerve sheath tumour which are extremely malignant, but very rare neoplasmas with unfavourable prognosis. Conclusion: Since both types of tumours are often located below the knee, phlebotomists and vascular surgeons should take them into account as differential diagnosis.

Short stripping of the incompetent great saphenous vein by InvisiGrip® vein stripper

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 77-81 ◽  
Author(s):  
A. G. Krasznai ◽  
E. C. M. Bollen ◽  
J. C. van der Kley ◽  
R. J. Th. J. Welten ◽  
G. M. J. M. Welten
Keyword(s):  
Success Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Nerve ◽  
Preoperative Selection ◽  
Superficial Wound ◽  
Good Cosmetic ◽  
Surgical Device ◽  
Femoral Nerve Injury ◽  
Selection Of

SummaryOur aim is to describe the results of a new short stripping technique for the treatment of the incompetent great saphenous vein (GSV) using a new developed surgical device. Patients, methods: 397 patients (498 legs) were treated with the InvisiGrip® Vein Stripper, which removes the GSV through a single groin incision, endovascular cutting and antegrade stripping by inversion. We reported the surgical success rate and postprocedural complications. Results: The mean age was 51 years, 74% were women. The success rate for removal of the GSV was 95%. The 23 failures were half patient related, half device related. In 82% of the strippings, one or two attempts were needed to successfully remove the GSV, which was done by invagination in 80%. Age, gender, BMI ≥30 kg/m2 and male GSV diameter were not associated with the number of attempts. Superficial wound infection, haematoma and temporary saphenous and femoral nerve injury occurred in 6 (1.6%), 0, 3 (0.8%) and 7 (1.9%) patients, respectively. Conclusion: The InvisiGrip® is highly successful for the removal of the GSV using short inverting stripping. Furthermore, it is simple, safe, associated with good cosmetic results and no preoperative selection of patients is necessary.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

Fibrinolytic Activity of Human Veins in Arms and Legs

1968 ◽  
Vol 20 (01/02) ◽  
pp. 247-256 ◽  
Author(s):  
M Pandolfi ◽  
B Robertson ◽  
S Isacson ◽  
Inga Marie Nilsson
Keyword(s):  
Saphenous Vein ◽  
Fibrinolytic Activity ◽  
Great Saphenous Vein ◽  
Normal Subjects ◽  
Vasa Vasorum ◽  
Tissue Sections ◽  
Below The Knee ◽  
The Media

SummaryA modification of the fibrin slide method of Todd permitting a semiquantitative estimation of the fibrinolytic activity in tissue sections is described. By means of this technique, the authors have studied the fibrinolytic activity of the great saphenous vein and of superficial veins of the arm and leg in patients suffering from varices and in normal subjects. It was found that:1. Fibrinolytic activity is localized, in these vessels, mainly to the vasa vasorum of the adventitia. The media is moderately active. Intimal cells are active only when detached.2. The great saphenous vein is more active above than below the knee.3. The veins of the arm are definitely more active than the veins of the leg.4. The activator of plasminogen demonstrated in the sections by the fibrin slide method is a fairly stable enzyme still active after exposure to 60° C and resistent to moderate variations of pH.

Risk factors for endovenous heat-induced thrombosis after endovenous radiofrequency ablation of the great saphenous vein

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Raffaele Serra ◽  
Nicola Ielapi ◽  
Tiberio Rocca ◽  
Luca Traina ◽  
Stefano De Franciscis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein

Morphometric characteristics of competent proximal valves of the great saphenous vein and superficial femoral vein in vivo according to ultrasound angioscanning data

2019 ◽  
Vol 18 (3) ◽  
pp. 16-22
Author(s):  
E. K. Gavrilov ◽  
H. L. Bolotokov ◽  
E. A. Babinets
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Lower Boundary ◽  
Average Diameter ◽  
Lower Limbs ◽  
Functional Test ◽  
Natural Form ◽  
Superficial Femoral Vein ◽  
Venous Diameter

Introduction. It seems relevant to study the ultrasound anatomy and physiology of the proximal valve segments of the superficial femoral vein (SFV) and the great saphenous vein (GSV) to develop effective reconstructive surgical interventions on venous valves in chronic vein diseases.The aim of the survey was to study the ultrasound anatomy of the venous wall, the size and shape of the proximal SFV and GSV valves are normal at rest and during the functional test Valsalva.Material and methods. Proximal valve SFV studies were performed in 144 lower limbs in 115 people (mean age 51.1 ± 14.4 years, 60 women and 55 men), proximal GSV valves studies - in 82 lower limbs in 67 persons (average age 45, 1 ± 13.3 years, 33 women, 34 men). A longitudinal and transverse ultrasound scanning of the femoral vein bifurcation and safenofemoral junction areas were performed, the structures of the proximal SFV and GSV valves were visualized, the valve shape was measured and the diameter of the veins was measured at the level valves at the base of the valves (inlet diameter), at the point of maximum ectasia (diameter of ectasia), at the upper border of the valve (diameter of the outlet), as well as measuring the length of the valve a (length to ectasia, the total length of the valve). The degree of ectasia over the valve was judged by calculating the relative venous diameter change (RVDC).Results. the average diameter of the SFV at the level of the lower boundary of its first valve was 10.01 ± 1.44 mm. The average diameter of the SFV at the level of the maximum ectasia of its first valve was 13,1±2 mm. The average value of the index of RVDC for SFV was 31%±10,4%. An increase in the diameter of the vein in the zone of supravalvular ectasia up to 20% corresponded to the spindle-shaped valve, more than 20% - to the clavate form, which was noted in the majority of the examined. The change in the relative venous diameter of the SFV on the Valsalva test was 38,2%±12,4%. The average diameter of the GSV at the base of the first valves was 6,07±1,25 mm. The average diameter of the GSV at the level of the maximum ectasia of the osteal valve was 9,44±1,69 mm. The average RVDC for GSV was 58%±24%.Conclusion. the natural form of proximal SFV and GSV valves is clavate with presence of the significant supravalvular ectasia, which was noted in the majority of the subjects alone and in all during the performance of the Valsalva functional test.

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