Comparison of recurrence rate and hemodynamic effect among various technical approaches for ligations of great saphenous vein in treatment of varicose veins

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 23-27
Author(s):  
Hirai ◽  
Iwata ◽  
Sawazaki
Keyword(s):  
Recurrence Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Hemodynamic Effect ◽  
Recurrence Rates ◽  
Primary Varicose Veins ◽  
Hemodynamic Improvement ◽  
Group 2 ◽  
One Year

Background: The aim of this study was to compare the recurrence rate and hemodynamic effect retrospectively among various technical approaches for ligations of the great saphenous vein in the treatment of primary varicose veins. Patients and methods: 455 limbs with primary uncomplicated great saphenous varicose veins, which underwent ligations of the great saphenous vein followed by sclerotherapy, were classified into 5 groups according to different ligation techniques. The recurrence rate and hemodynamic effect, evaluated by the photoplethysmographic technique, were compared among the 5 groups at one year intervals up to 5 years. Results: The 3-ligation technique, in which the great saphenous vein was resected at the groin, thigh, and calf, showed a significantly lower recurrence rate at the 5-year follow-up. The recurrence rates were 27.7, 62.0, 58.5, and 91.9% in the 3-ligation group, 2-ligation group at the groin and thigh, 2-ligation group at the thigh and calf, and 1-ligation group at the thigh, respectively. A lower hemodynamic improvement was observed in the latter two groups. A significantly higher recurrence rate was shown even in the 3-ligation group, when all tributaries were not dissected at the sapheno-femoral junction (50.2 vs. 27.7%, p < 0.01). Conclusions: The 3-ligation technique followed by sclerotherapy, which includes the resection of the great saphenous vein for as long as possible, and dissection of all tributaries at the groin, thigh, and calf, is one of the important choices of minimum invasive treatments for varicose veins, although this technique is not a fully alternative procedure to the stripping operation.

Short-term results of isolated phlebectomy with preservation of incompetent great saphenous vein (ASVAL procedure) in primary varicose veins disease

2016 ◽  
Vol 32 (9) ◽  
pp. 601-607 ◽  
Author(s):  
Igor A Zolotukhin ◽  
Evgeny I Seliverstov ◽  
Elena A Zakharova ◽  
Alexander I Kirienko
Keyword(s):  
Recurrence Rate ◽  
Local Anesthesia ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Primary Varicose Veins ◽  
One Year

Objective To establish an effect of isolated phlebectomy in patients with incompetent great saphenous vein (Ambulatory Selective Varices Ablation under Local anesthesia (ASVAL) procedure) on the reflux and diameter of the trunk and to assess recurrence rate of varicose veins at one year. Material and methods We conducted a prospective study on patients with primary varicose veins and with C2 or C2,3 or C2,3,4 or C2,4 classes of chronic venous disease and great saphenous vein incompetence. The study included 67 patients (51 women and 16 men; 75 limbs in total). Age varied from 17 to 71 years; mean age was 46.8 years (SD 13.9). We recorded the presence or absence of reflux in the great saphenous vein with duplex ultrasound before and after surgery. The recurrence of varicose veins was evaluated at 12 months. All the patients underwent isolated phlebectomy with preservation of incompetent great saphenous vein (ASVAL procedure) under local anesthesia. Results At one year after removing of tributaries of the incompetent trunk, 66% of them were competent. Reflux persisted in 17% of great saphenous veins with reflux above mid-thigh and in 61% of trunks with reflux extended below the mid-thigh (p = 0.0004). The diameter of all the veins decreased significantly no matter reflux disappeared or not. Varicose veins reoccurred in 13.5% cases. In 6.5% of limbs with a reflux above the mid-thigh, the recurrence was registered at one year, while in the limbs with the reflux below the mid-thigh at a baseline, the recurrence rate was 25% (p = 0.036). Conclusion Isolated phlebectomy with a preservation of incompetent great saphenous vein leads to disappearance of reflux in a majority of cases and to significant decrease of vein diameter in all the cases. ASVAL procedure could be considered as a less aggressive and less expensive approach in selected cases. Clear indications for isolated phlebectomy need to be established.

Cyanoacrylate adhesive embolization and sclerotherapy for primary varicose veins

2017 ◽  
Vol 33 (8) ◽  
pp. 547-557 ◽  
Author(s):  
Krishna Prasad Bellam Premnath ◽  
Binu Joy ◽  
Vijayakumar Akondi Raghavendra ◽  
Ajith Toms ◽  
Teena Sleeba
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Cyanoacrylate Glue ◽  
Cyanoacrylate Adhesive ◽  
Venous Clinical Severity Score ◽  
Primary Varicose Veins ◽  
Vein Reflux

Various treatment methods are available for the treatment of varicose veins, and there has been a recent surge in the usage of cyanoacrylate glue for treating varicose veins. Purpose To investigate the technical possibility, efficiency and safety of cyanoacrylate adhesive embolization and sclerotherapy using commonly available n-butyl cyanoacrylate glue for the treatment of primary varicose veins due to great saphenous vein reflux with or without incompetent perforators. Materials and Methods One hundred forty-five limbs of 124 patients with varicose veins due to great saphenous vein reflux were subjected to cyanoacrylate adhesive embolization and sclerotherapy – adhesive embolization of great saphenous vein in the thigh and perforators using cyanoacrylate followed by sclerotherapy of any residual varicose veins in the leg. Procedural success, venous closure rates and clinical improvement were assessed. Follow-up for 1, 3, 6, 9 and 12 months was obtained. Results Technical success rate was 100%. Saphenous vein closure rate was 96.5% at one year. There was no femoral venous extension of cyanoacrylate in any of the patients. Posterior tibial vein extension of cyanoacrylate was seen in three patients (2.6%) without untoward clinical effect.Significant improvement was found in venous clinical severity score (VCSS) from a baseline mean of 7.98 ± 4.42 to 4.74 ± 3, 1.36 ± 1.65 and 0.79 ± 1.19 at 1, 6 and 12 months’ follow-up. Ulcer healing rate was 100%. Conclusion Cyanoacrylate adhesive embolization and sclerotherapy for the treatment of primary varicose veins is efficacious and can be performed as an outpatient procedure, but has a guarded safety profile due to its propensity to cause deep venous occlusion if not handled carefully.

The Elastic Properties of the Human Great Saphenous Vein in Relation to Primary Varicose Veins

1974 ◽  
Vol 52 (2) ◽  
pp. 153-157 ◽  
Author(s):  
J. Kenneth Booking ◽  
Margot R. Roach
Keyword(s):  
Elastic Properties ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Simultaneous Measurements ◽  
Saphenous Veins ◽  
Before And After ◽  
Laplace’S Law ◽  
Primary Varicose Veins ◽  
Laplace's Law

Simultaneous measurements of pressure and volume were made on nine great saphenous veins obtained at autopsies and nine great saphenous veins that were stripped during surgery from patients with primary varicose veins. Similar measurements were also made on six great saphenous veins obtained at autopsy before and after they were held at 100 cm H2O for 4 h. Circumferential tensions were calculated from Laplace's law (tension = pressure × radius).The great saphenous veins from patients with primary varicose veins had significantly greater radii and were more distensible than the normal great saphenous veins. After being held at 100 cm H2O for 4 h, the normal great saphenous veins became less distensible and their radii at distending pressures increased.Due to the great difference in radii, the circumferential tension on a great saphenous vein from a patient with primary varicose veins is much greater than that on a normal great saphenous vein at the same distending pressure. However, the physical stresses exerted on the great saphenous veins during the stripping operations may influence our results in some unknown way.

scholarly journals Modification of Primary Avalvular Varicose Anomaly after endovenous radiofrequency ablation

Phlebologie ◽  
2019 ◽  
Vol 48 (06) ◽  
pp. 373-376
Author(s):  
Daniele Bissacco ◽  
Silvia Stegher ◽  
Fabio Massimo Calliari ◽  
Marco Piercarlo Viani
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Ultrasound Examination ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Invasive Procedure ◽  
Before And After ◽  
Primary Varicose Veins ◽  
Partial Thrombosis

AbstractPrimary avalvular varicose anomaly (PAVA) is a new medical concept defined as primary varicose veins resembling neovascularized tissue on ultrasound examination. PAVAs could be misdiagnosed as recurrence at the saphenofemoral or saphenopopliteal junction, but no studies have yet examined their role before and after venous invasive procedure. In this report, we describe a case of PAVA in a 39-year-old man with symptomatic varicose veins and great saphenous vein truncal incompetence. Six months after radiofrequency ablation of the great saphenous vein, duplex ultrasound revealed complete occlusion of great saphenous vein and partial thrombosis of the still incompetent PAVA.

Does the number of pregnancies affect patterns of great saphenous vein reflux in women with varicose veins?

2010 ◽  
Vol 25 (4) ◽  
pp. 190-195 ◽  
Author(s):  
C A Engelhorn ◽  
M F Cassou ◽  
A L Engelhorn ◽  
S X Salles-Cunha
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasonography ◽  
Skin Changes ◽  
Colour Flow ◽  
Primary Varicose Veins ◽  
Saphenofemoral Junction ◽  
Vein Reflux

Objectives Impact of pregnancies on great saphenous vein (GSV) reflux patterns deserves clarification. Which GSV segment is most affected? Is the saphenofemoral junction (SFJ) involved? Methods Colour-flow duplex ultrasonography was performed in 583 women extremities with primary varicose veins (clinical, aetiological, anatomical and pathological elements [CEAP C2]), without oedema, skin changes or ulcer. Women with previous thrombosis or varicose surgery were excluded. GSV reflux sources and drainage points were located at SFJ, thigh, knee and calf. Prevalence of most proximal reflux source was noted as a function of 0, 1, 2, 3 and 4 or more pregnancies. χ2 statistics was employed. Results Prevalence of GSV reflux was not dependent on 0, 1, 2, 3 or ≥4 pregnancies: 75%, 69%, 79%, 70% and 76% for right leg ( P = 0.79) and 78%, 81%, 82%, 79% and 73% for left leg ( P = 0.87), respectively. Prevalence of SFJ reflux and GSV reflux, starting at the thigh, knee or calf, was similar and showed no tendencies to increase with number of pregnancies. Conclusions Number of pregnancies did not influence GSV reflux patterns in women with primary varicose veins.

A comparison of three tumescent delivery systems in endovenous laser ablation of the great saphenous vein

Vascular ◽  
2013 ◽  
Vol 21 (6) ◽  
pp. 375-379 ◽  
Author(s):  
Firat H Altin ◽  
Baris Kutas ◽  
Tevfik Gunes ◽  
Selim Aydin ◽  
Bortecin Eygi
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Delivery Systems ◽  
Endovenous Laser Ablation ◽  
Tumescent Solution ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Different systems for delivering tumescent solution exist in endovenous laser ablation (EVLA). This study evaluated three different tumescent delivery systems in patients with primary varicose veins due to great saphenous vein reflux who were treated with EVLA. In this prospective non-randomized study, 60 patients with isolated GSV varicose veins were divided into three groups. All patients received EVLA treatment. Three different tumescent solution delivery systems were used. Systems consisted of a needle and a syringe in Group 1, a needle connected to an infusion bag system in Group 2 and a peristaltic infiltration pump in Group 3. Tumescent delivery durations were in Group 1: 6.56 SD 1.18 minutes, Group 2: 6.05 SD 2.19 minutes and Group 3: 5.19 SD 1.15 minutes ( P = 0.014). In the outcomes of the study there were no significant difference between groups. Although peristaltic pump systems might provide shorter tumescent delivery durations without hand fatigue, shorter duration does not have any practical importance (about 1 minute and also it is not cost-effective. For delivering tumescent solutions in EVLA procedures, there was no major superiority between systems.

ClariVein™ – One year results of mechano-chemical ablation for varicose veins in a multi-ethnic Asian population from Singapore

2018 ◽  
Vol 33 (10) ◽  
pp. 687-694 ◽  
Author(s):  
Shao N Khor ◽  
Jiang Lei ◽  
Jia W Kam ◽  
Steven Kum ◽  
Yih K Tan ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Asian Population ◽  
Vein Occlusion ◽  
Early Results ◽  
Short Saphenous Vein ◽  
Chemical Ablation ◽  
One Year

Objectives This study assessed the effectiveness and patient experience of ClariVein for varicose veins and chronic venous insufficiency (CVI) in a multi-ethnic Asian population from Singapore. Methods A total of 121 patients underwent mechano-chemical ablation. Patients were reviewed at an interval of one week, and at 3, 6 and 12 months post procedure and underwent Duplex ultrasound with patient satisfaction assessment. Results At three months of follow-up, the great saphenous vein and short saphenous vein occlusion rates were 90.8% and 96.0%, respectively. At six months of follow–up, the GSV and short saphenous vein occlusion rates were 86.9% and 90.9%, respectively. At one year, great saphenous vein and short saphenous vein occlusion rates were 84.8% and 94.3%, respectively. Conclusions Early results are similar to what is described so far in the mechano-chemical ablation literature but recurrences are more than expected at one year. This is disappointing but is tempered by the fact that the majority of patients were asymptomatic and required no reintervention.

scholarly journals The outcome of the Trendelenburg procedure with stripping vs. no stripping in the management of varicose veins

2020 ◽  
Vol 14 (03) ◽  
pp. 110-113
Author(s):  
Jibran Mohsin ◽  
Muhammad Haris Janjua ◽  
Jumana Fatima ◽  
Muhammad Usman Siddique ◽  
Muhammad Yasir Naseem ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Controlled Trial ◽  
Treatment Options ◽  
P Value ◽  
Chi Square ◽  
Group A ◽  
Group B

Background: Varicose veins is a common problem in Pakistan with multiple treatment options. One of its recommended and commonly performed surgical treatment includes the flush ligation of Saphenofemoral junction (Trendelenburg procedure) with stripping of great saphenous vein and avulsion of varicosities which is a cumbersome process. This study aims to evaluate the effect of stripping of great saphenous vein on the recurrence rate. Patients and methods: A randomized controlled trial was conducted in the Surgical Unit I, Services Hospital, Lahore over a period of 22 months from 20-09-2016 to 20-07-2018. Seventy patients were divided equally into two groups of 35 patients each i.e. Trendelenbrug procedure and avulsion of varicosities with stripping down to the knee, (Group A) versus Trendelenbrug procedure and avulsion of varicosities without stripping (Group B). Recurrence at 12 weeks was noted. SPSS version 17.0 was used to analyze data. Comparison of recurrence and stratified confounding factors such as age, gender, and BMI were assessed by the chi-square test (significant p-valve ≤0.05). Results: In group A, 32 out of 35 patients were male (91.43%) and 3 (8.57%) were female. While in group B, 31 out of 35 patients were male (88.87%) and 4 (11.43%) were female. Four out of 35 (11.43%) patients in group A whereas 6 (17.14%) group B patients (p-value=0.494) had a recurrence in the perforators below the knee at 12 weeks. Stratification (p-values) of recurrence rate with respect to age (<40 years: 0.41 versus ≥ 40 years:0.905), gender (female: p-value not applicable versus male: 0.96) and BMI was done (<25 kg/m2: 0.36 versus ≥ 25 kg/m2: 0.901) Conclusions: Stripping does not significantly affect the outcome of varicose vein surgery in relation to the recurrence rate at 12 weeks and recurrence was independent of age, gender, and BMI of patients.

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