The Durability of Polidocanol Endovenous Microfoam Treatment Effect on Varicose Vein Symptoms and Appearance in Patients with Saphenofemoral Junction Incompetence: One-Year Results from the VANISH-2 Study

2014 ◽  
Vol 2 (1) ◽  
pp. 112 ◽  
Author(s):  
K.L. Todd ◽  
D. Wright ◽  
E. Orfe
Keyword(s):  
Treatment Effect ◽  
Varicose Vein ◽  
One Year ◽  
Saphenofemoral Junction

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.

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 Surgical Outcomes of Varicose Veins at Universal College of Medical Sciences, Bhairahawa, Nepal

2018 ◽  
Vol 4 (2) ◽  
pp. 14-16
Author(s):  
Santosh Shah ◽  
Sumod Koirala ◽  
Saroj Pradhan ◽  
Ashok Pradhan
Keyword(s):  
Surgical Treatment ◽  
Varicose Vein ◽  
Lower Limb ◽  
Surgical Outcomes ◽  
Varicose Veins ◽  
Medical Sciences ◽  
Operative Complications ◽  
Short Saphenous Vein ◽  
One Year ◽  
Post Operative Complications

INTRODUCTION: This study was conducted to analyse the surgical outcomes of varicose vein at Universal College of Medical Sciences (UCMS), Bhairahawa. MATERIALS AND METHODS: A hospital based prospective study done at UCMS, Bhairahwa, Nepal over the period of one year, where all the patients who had lower limb varicose vein underwent surgery were analyzed. RESULTS: A total of 25 cases of varicose vein were operated at UCMS from August 2015 to July 2016. The post-operative complications like pain, wound abscess, aching, itching were minimal.  CONCLUSION: Surgical treatment by SFJ ligation with stripping long and short saphenous vein is an established effective treatment of varicose vein in our center with minimal post-operative complications. Journal of Universal College of Medical Sciences (2016) Vol.04 No.02 Issue 14, page: 14-16  

scholarly journals Higher treatment effect after total knee arthroplasty is associated with higher patient satisfaction

2020 ◽  
Author(s):  
Jörg Lützner ◽  
Franziska Beyer ◽  
Klaus-Peter Günther ◽  
Jörg Huber
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Treatment Effect ◽  
Treatment Effects ◽  
Oxford Knee Score ◽  
Individual Treatment ◽  
Total Knee ◽  
The Mean ◽  
One Year

Abstract Purpose The aim of this study was to investigate what influence the treatment effect after total knee arthroplasty (TKA) had on patient satisfaction. Methods Prospective registry data of a University-based arthroplasty centre were used. 582 patients with unilateral bicondylar TKA were analyzed. Treatment effect (TE) was deduced from Oxford Knee Score (OKS) before and one year after surgery. Positive values correspond to improved symptoms (maximum 1.0 reflect no symptoms at all) and negative values correspond to deterioration of symptoms. Satisfaction on a visual-analogue scale from 0 to 10 and the willingness to undergo TKA surgery again was assessed one year after surgery. Results The mean OKS improved from 22.1 before to 36.7 one year after TKA. Treatment effects ranged from 1.0 to –0.62 with a mean TE of 0.56. Taking an individual treatment effect of 0.2 as a cut-off between responder and non-responder, a total of 85.8% would be classified as responder after TKA. The mean satisfaction score with the TKA was 8.1. There was a significant correlation between the individual treatment effect and satisfaction after TKA (p < 0.001). The majority of patients (84.5%) would undergo surgery again. Patients not willing to undergo surgery again or those uncertain about this had lower satisfaction scores, a lower treatment effect and were more often female compared to patients who would undergo surgery again. Conclusion Higher individual treatment effects resulted in higher patient satisfaction and willingness to undergo surgery again. However, some patients with a relatively low treatment effect were highly satisfied, which indicates the need for both information. Level of evidence II.

A medial approach for open redo groin surgery for varicose vein recurrence

Phlebologie ◽  
2013 ◽  
Vol 42 (05) ◽  
pp. 247-252 ◽  
Author(s):  
O. Nelzén
Keyword(s):  
Varicose Vein ◽  
Operating Time ◽  
Duplex Ultrasound ◽  
Clinical Severity ◽  
Wound Infections ◽  
Medial Approach ◽  
Venous Clinical Severity Score ◽  
One Year ◽  
The One

SummaryAims: To describe the technique of a medial approach for redo groin surgery for varicose vein recurrence and to report the one year prospective results for this procedure.Method: The standardised technique employed is described. Prospective one year data regarding the effectiveness of this procedure was taken from a one year audit performed 2009–2010 at Skaraborg Hospital. Details regarding this patient cohort and the surgery performed were registered. The outcome was measured by using venous clinical severity score (VCSS) and the disease specific quality of life was measured with the Aberdeen varicose vein questionnaire (AVVQ). Venous duplex ultrasound scanning (DUS) was performed preoperatively, after 4–6 weeks and after one year.Results: Out of 255 venous operations 34 regarded redo groin surgery and these were assessed. Females dominated 25/34 and the median age was 55 years (range 26–80). All patients had a probable stump according to DUS. CEAP C3-C4 dominated 28 patients/ legs and C5-C6 in 4 legs. The median operating time was 69 minutes (range 35–120) and the operating time was significantly correlated to the number of incisions (p<0.001). The complication rate was 15 %, including 2 wound infections but no DVT or lymph leakage. Both the VCSS and the AVVQ scores were significantly improved after one year (p<0.001). After one year DUS detected recurrence in the groin was observed in 19 %, mostly neovascularisation.Conclusion: Redo groin surgery by a standardised medial approach is a safe and not an especially technically demanding technique that can be performed reasonably rapidly. The one year results are promising and the early DUS recurrence rate seems low.

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