Correlation of the anatomical distribution of venous reflux with clinical symptoms and venous haemodynamics in primary varicose veins

1998 ◽  
Vol 85 (2) ◽  
pp. 213-216 ◽  
Author(s):  
Sakurai ◽  
Gupta ◽  
Matsushita ◽  
Nishikimi ◽  
Nimura
Keyword(s):  
Clinical Symptoms ◽  
Varicose Veins ◽  
Venous Reflux ◽  
Anatomical Distribution ◽  
Primary Varicose Veins

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.

Strip-tract revascularization as a source of recurrent venous reflux following high saphenous tie and stripping: results at 5–8 years after surgery

2014 ◽  
Vol 30 (8) ◽  
pp. 569-572 ◽  
Author(s):  
Alexandra E Ostler ◽  
Judy M Holdstock ◽  
Charmaine C Harrison ◽  
Barrie A Price ◽  
Mark S Whiteley
Keyword(s):  
Response Rate ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasonography ◽  
Venous Reflux ◽  
Primary Varicose Veins ◽  
And Inversion ◽  
Saphenofemoral Junction ◽  
Subfascial Endoscopic Perforator Surgery

Objective We have previously reported strip-tract revascularization 1 year following high saphenous ligation and inversion stripping. This study reports the 5–8 year results in the same cohort. Methods Between 2000 and 2003, 72 patients presented with primary varicose veins and had undergone high saphenous ligation and inversion stripping plus phlebectomies with or without subfascial endoscopic perforator surgery. Of the 64 patients who had attended for follow-up at 1 year, 35 patients (male:female, 16:19; 39 legs) underwent duplex ultrasonography 5–8 years after surgery (response rate 55%). Duplex ultrasonography was performed and all strip-tract revascularization and reflux and groin neovascularization was documented. Results Eighty-two percent of legs of patients showed some evidence of strip-tract revascularization and reflux. Full and partial strip-tract revascularization and reflux was seen in 12.8% and 59% of limbs of patients, respectively, and 10.2% limbs of patients had neovascularization only at the saphenofemoral junction only. Seven limbs of patients showed no revascularization. Conclusion Five to eight years after high saphenous tie and stripping, 82% of legs of patients showed some strip-tract revascularization and reflux and 12% showed total revascularization and reflux of the stripped great saphenous vein.

scholarly journals Symptomatic recurrent varicose veins due to primary avalvular varicose anomalies (PAVA): A previously unreported cause of recurrence

2018 ◽  
Vol 6 ◽  
pp. 2050313X1877716
Author(s):  
Alice M Whiteley ◽  
Judith M Holdstock ◽  
Mark S Whiteley
Keyword(s):  
Varicose Veins ◽  
Duplex Ultrasonography ◽  
Venous Reflux ◽  
Recurrent Varicose Veins ◽  
Saphenous Veins ◽  
Primary Procedure ◽  
Previous Trauma ◽  
Primary Varicose Veins ◽  
Endovenous Treatment ◽  
Saphenofemoral Junction

A 56-year-old woman presented in 2006 with symptomatic primary varicose veins in her right leg. Venous duplex ultrasonography at that time showed what appeared to be “neovascular tissue” around the saphenofemoral junction. However, there had been no previous trauma or surgery in this area. This appearance has subsequently been described as primary avalvular varicose anomalies. She underwent endovenous treatment at that time. In 2018, she presented with symptomatic recurrent varicose veins of the same leg. Venous duplex ultrasonography showed successful ablation of the great saphenous and anterior accessory saphenous veins. All of the recurrent venous reflux was arising from the primary avalvular varicose anomalies. This report shows that primary avalvular varicose anomalies is a previously unreported cause of recurrent varicose veins and leads us to suggest that if found, treatment of the primary avalvular varicose anomalies should be considered at the primary procedure.

The haemodynamic causes of skin changes in limbs with primary varicose veins

2018 ◽  
Vol 34 (2) ◽  
pp. 88-97
Author(s):  
Yasushi Shiraishi
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Normal Group ◽  
Inflow Rate ◽  
Venous Reflux ◽  
Skin Changes ◽  
Significant Difference ◽  
Arterial Inflow ◽  
Primary Varicose Veins ◽  
Air Plethysmography

Objectives To investigate the haemodynamic causes of skin changes in limbs with primary varicose veins, which were assessed with air plethysmography. Methods Five hundred seventeen consecutive patients with axial reflux in the great saphenous vein (varicose vein group) and 248 normal subjects (normal group) were investigated. Varicose vein group patients were divided into two groups according to whether they did (C4–6) or did not (C2–3) have skin changes. Several parameters obtained using air plethysmography were compared among the normal group, C2–3 and C4–6 patients. Results Although there was no significant difference in the regurgitation index to quantify venous reflux in C2–3 and C4–6 patients, the maximum arterial inflow rate increased (normal group < C2–3 < C4–6), even in limbs with a small amount of venous reflux. Conclusions This study suggests that it is not essential to increase the venous reflux rate in skin change development; rather, it is based on various pathophysiological conditions that increase the arterial inflow rate.

scholarly journals Hemodynamic assessment of femoropopliteal venous reflux in patients with primary varicose veins

1997 ◽  
Vol 26 (2) ◽  
pp. 260-264 ◽  
Author(s):  
Tsunehisa Sakurai ◽  
Masahiro Matsushita ◽  
Naomichi Nishikimi ◽  
Yuji Nimura
Keyword(s):  
Varicose Veins ◽  
Venous Reflux ◽  
Hemodynamic Assessment ◽  
Primary Varicose Veins

Influence of Superficial Venous Ablation on Deep Venous Dilation and Reflux in Patients With Saphenous Varicose Veins

2020 ◽  
Vol 54 (8) ◽  
pp. 687-691
Author(s):  
Toshiya Nishibe ◽  
Masayasu Nishibe ◽  
Shinobu Akiyama ◽  
Saori Nukaga ◽  
Koki Maekawa ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Femoral Vein ◽  
Volume Overload ◽  
Venous Reflux ◽  
Venous Filling ◽  
Primary Varicose Veins ◽  
Venous Volume ◽  
The Common ◽  
Air Plethysmography ◽  
Deep Vein

Background: To investigate the influence of superficial venous ablation on deep venous dilation and reflux in patients with saphenous varicose veins, and to elucidate the association between superficial venous reflux and deep venous morphology and hemodynamics. Methods: The data of 154 patients with 223 limbs, who underwent endovenous radiofrequency ablation (RFA) of the great saphenous vein for primary varicose veins between September 2014 and March 2016 in Eniwa Midorino Clinic, were retrospectively analyzed. Overall venous hemodynamics of the leg, including functional venous volume (VV) and venous filling index (VFI), was assessed using air-plethysmography. Saphenous and deep vein reflux and diameter were evaluated with duplex scanning. Results: Hemodynamic and morphologic changes were evaluated before and 1 month after RFA. The VV and VFI were significantly decreased in postoperative values than in preoperative values ( P < .001). Limbs with deep venous reflux significantly decreased postoperatively than preoperatively ( P < .001). There were significant differences in the diameter of the common femoral vein (CFV) and popliteal vein (PV) between the preoperative and postoperative values ( P < .001). There were strong to moderate correlations between the VV and the diameter of the CFV or PV (CFV, r = 0.47, P < .001; PV, r = 0.35, P < .001), while there were moderate to weak correlations between the VFI and the diameter of the CFV or PV (CFV, r = 0.23, P < .001; PV, r = 0.33, P <.001). Conclusions: Superficial venous ablation significantly reduced deep venous dilation and reflux in patients with saphenous varicose veins. Significant correlations existed between the VV or VFI, which reflected superficial venous reflux, and the diameter of the deep veins. These findings reveal that volume overload due to superficial venous reflux is associated with deep venous morphology and hemodynamics.

Patterns of Venous Reflux in 1,027 Lower Limbs with Primary Varicose Veins

2017 ◽  
Vol 41 (2) ◽  
pp. 59-65 ◽  
Author(s):  
Victoria Carrison ◽  
Brooke Tompkins ◽  
Lisa Fronek ◽  
Nicole Loerzel ◽  
Nisha Bunke
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Venous Intervention ◽  
Lower Limbs ◽  
Venous Reflux ◽  
Female Ratio ◽  
Primary Varicose Veins ◽  
Male To Female ◽  
Saphenofemoral Junction

Objective The purpose of this study was to investigate the anatomical patterns of superficial venous reflux in patients presenting with primary varicose veins. Methods Ultrasound scans, detailed vein maps, and histories of patients presenting to a single vein center were retrospectively reviewed. Patients included in the study were those presenting with primary varicose veins and classified as clinical, etiologic, anatomic, and pathophysiologic classes 2 through 4. Patients with histories of venous intervention, malformations, active ulcerations, or deep system abnormalities were excluded from this study. Results Overall, 1,027 limbs of 617 patients met the inclusion criterion. The male to female ratio was 1:6.0. Varicose veins were attributed to reflux in the great saphenous vein (GSV) 66% (n = 679) of the time. When GSV reflux was present, the saphenofemoral junction was incompetent 83% of the time. Six percent of varicose veins were attributed to the anterior accessory saphenous vein. Small saphenous vein (SSV) reflux was demonstrated in 34.8% (n = 357). The thigh extension of the SSV and vein of Giacomini demonstrated reflux in 7% (n = 69) and 1% (n = 15) of limbs, respectively. Reflux of nonsaphenous origin was present in 19% (n = 198) of limbs (isolated tributary reflux). Conclusion The variations of superficial venous reflux in patients presenting with primary varicose veins are diverse and complex. Therefore, thorough duplex ultrasound is necessary in all patients with primary varicose veins to evaluate the precise source of reflux to determine therapeutic options.

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