Primary varicose veins

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 133-137
Author(s):  
H. Partsch
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Daily Practice ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Primary Varicose Veins ◽  
The Cost ◽  
Convincing Data ◽  
Long Term Studies

SummaryBackground: Compression stockings are widely used in patients with varicose veins. Methods: Based on published literature three main points are discussed: 1. the rationale of compression therapy in primary varicose veins, 2. the prescription of compression stockings in daily practice, 3. studies required in the future. Results: The main objective of prescribing compression stockings for patients with varicose veins is to improve subjective leg complaints and to prevent swelling after sitting and standing. No convincing data are available concerning prevention of progression or of complications. In daily practice varicose veins are the most common indication to prescribe compression stockings. The compliance depends on the severity of the disorder and is rather poor in less severe stages. Long-term studies are needed to proof the cost-effectiveness of compression stockings concerning subjective symptoms and objective signs of varicose veins adjusted to their clinical severity. Conclusion: Compression stockings in primary varicose veins are able to improve leg complaints and to prevent swelling.

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.

What is the Correct Period of Bandaging following Sclerotherapy?

1986 ◽  
Vol 1 (3) ◽  
pp. 217-220 ◽  
Author(s):  
P. Reddy ◽  
J. Wickers ◽  
T. Terry ◽  
P. Lamont ◽  
J. Moller ◽  
...  
Keyword(s):  
Scoring System ◽  
Randomized Trials ◽  
Varicose Veins ◽  
Objective Assessment ◽  
Injection Sclerotherapy ◽  
Additional Advantage ◽  
Long Term Follow Up ◽  
Primary Varicose Veins

Two consecutive randomized trials following injection sclerotherapy for varicose veins compared 3 and 6 weeks bandaging in 148 patients and 1 to 3 weeks bandaging in 130 patients. Objective assessment and patient's symptoms, using a scoring system, correlated well and showed that there was no difference whatsoever between 3 and 6 weeks' bandaging after a 6 year follow-up. In the second trial, the patients who were bandaged for 3 weeks were significantly better (P < 0.001) than after only one week of bandaging at a maximum follow up of 4 years. Long term follow up of injection sclerotherapy for primary varicose veins suggests that 3 weeks is superior to 1 week bandaging, but that there is no additional advantage in continuing bandaging for six weeks.

Venous Volumetry In The Assessment Of The Post-Thrombotic Limb

1981 ◽  
Author(s):  
C V Ruckley ◽  
H M Crawshaw ◽  
J Seaton
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Response To Treatment ◽  
Venous Disease ◽  
Clinical Relapse ◽  
Non Invasive ◽  
Coefficients Of Variation ◽  
Primary Varicose Veins

The reproducibility of venous volumetry has been evaluated in 20 normal legs (N), 20 legs with primary varicose veins (W) and 30 with stable post-thrombotic chronic venous insufficiency (CVI).The test has shown significant differences between the groups in mean relative expelled volume (EV rel, ccs): N 1.65 ± SD 0.66; W 1.01 ± 0.40; CVI 0.64 ± 0.39 and in half refilling time (T3 secs): N 23.9 ± 11.5; W 11.8 ± 7.4; CVI 3.6 ± 1.8. The percent coefficients of variation in tests repeated at intervals of up to a month were as follows.The reproducibility of the test confirms its value as a non-invasive means of measuring the severity of postthrombotic venous disease and thus as a means of assessing response to treatment. Serial volumetric tests on 25 patients before and for up to 12 months after Linton operations for chronic venous insufficiency show significant early improvements in expelled volume. But in many of these patients the refilling time tends to remain short indicating residual valvular incompetence and the possibility of clinical relapse in the long term.

Varicose veins: A critical review of the definition and the therapeutical options

VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 344-358 ◽  
Author(s):  
Jeanneret ◽  
Karatolios
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Treatment Modalities ◽  
Therapeutic Approaches ◽  
New Techniques ◽  
Definition Of ◽  
Vein Disease ◽  
Therapeutical Options ◽  
Long Term Studies

This review intends to give an overview of the present therapeutic options for varicose vein disease. The definition of varicose vein disease and its recurrence are made and discussed with new aspects including duplexsonography assessment. All therapeutic approaches have developed and refined their treatment modalities, the open surgical as well as the endovenous techniques. In particular the “new” endovenous techniques are described with regard to safety and outcome, the published literature in this respect is summarized. The studies comparing the different techniques are listed, the prospective long term studies comparing the new techniques with the so called gold standard (open surgery) shall decide on the fate of the different techniques.

Endovascular Laser Therapy versus Open Surgery for the Treatment of Primary Varicose Veins of the Lower Limb

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem Abd Elsalam Mohamed ◽  
Assist. Prof. Dr. Ramez Mounir Wahba ◽  
Fawzy Salah Fawzy ◽  
Beshoy Maher Yacoub Gebrael
Keyword(s):  
Laser Therapy ◽  
Lower Limb ◽  
Severity Score ◽  
Open Surgery ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Surgery Group ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Primary Varicose Veins

Abstract Background Venous drainage of the lower extremities is accomplished by a network of superficial veins connected to the deep veins by small perforator veins. Through a variety of pathophysiological mechanisms, weakness develops in the vein wall that results in varicosity over time. Varicosities typically form in the greater and lesser saphenous veins but also develop in branch vessels. Obstruction of the iliac veins or inferior vena cava can result in extensive varicose veins Objective s: The aim of this work is to compare the outcome of endovascular laser therapy versus open surgery in management of primary varicose veins in lower limb. Patients and Methods Type of study is a prospective, randomized, clinical study. This study was conducted on 30 patients with primary varicose veins of the lower limb, 15 patients were subjected to endovascular laser therapy for treatment of varicose veins of the lower limb (EVLA group) and 15 patients were managed by standard open surgery for treatment of varicose veins of the lower limb (surgery group). The patients were randomized selected from surgery clinic in Eldemerdash Hospital. The work was carried out in the period from June 2017 to December 2018. Results Both groups were well matched regarding age(P = 0.352) and sex (P = 0.713), type of vein diseased(P = 0.913), CEAP classification (P = 0.910) and also regarding BMI (P = 0.761). Regarding preoperative venous clinical severity score, the median(IQR) for group A (surgery group) was (5), and for group B (laser group) was (5) without statistical significant differences between both groups (P value =0.524). Many studies have shown that there was some difference in between two methods of treatment of primary varicose veins of the lower limbs open vascular surgery and endovascular laser therapy. Regarding Six weeks post-operative VCSS assessment, the VCSS score in the surgery group was statistically significantly higher (p &lt; 0.001). However, at one and two years after the intervention The VCSS scores converged and the difference between the groups was no longer statistically significant. Conclusion The presented results show that intreatment of varicose veins with both endovascular laser ablation and open surgery there was improvement in the clinical status of the patient occur after both but EVLA was more effective early which was observed by measuring venous clinical severity score. EVLA show distinct advantages over open surgery especially in post operative pain, analgesia use and time needed to return to work.

Timing and duration of compression therapy after deep vein thrombosis

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 78-82 ◽  
Author(s):  
AC Bouman ◽  
AJ ten Cate-Hoek
Keyword(s):  
Deep Vein Thrombosis ◽  
Preventive Measure ◽  
Compression Therapy ◽  
Controlled Trials ◽  
Compression Stockings ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Optimal Duration ◽  
Deep Vein

After deep vein thrombosis (DVT) 20-50%, of patients develop post thrombotic syndrome (PTS). Up till now, there is no effective treatment for PTS and prevention is therefore of major importance. Compression therapy after DVT, with elastic compression stockings (ECS), is the only available preventive measure for PTS. However, the usefulness, timing, and duration of compression therapy are matters of debate. The effect of early compression on the long-term development of PTS is still unclear as studies performed so far have conflicting outcomes.16–19 The effectiveness of ECS therapy initiated in the sub-acute phase was assessed in three large randomized controlled trials. Kahn et al could not reproduce the large risk reduction found in the trials by Brandjes and Prandoni et al.20–22 Also for the optimal duration of ECS therapy, a certain conclusion has yet to be drawn. Therefore identification of patients who most likely will benefit from ECS therapy as well as the optimal ECS treatment strategy remain subjects for further study.

scholarly journals Improvement of Refractory Peripheral Edema With Multilayered Compression Bandaging: A Case Report

2018 ◽  
Vol 98 (9) ◽  
pp. 763-766 ◽  
Author(s):  
Jegy M Tennison ◽  
Jack B Fu ◽  
Eduardo Bruera
Keyword(s):  
Lower Extremity ◽  
Diuretic Therapy ◽  
Compression Therapy ◽  
Lower Extremity Edema ◽  
Compression Stockings ◽  
Peripheral Edema ◽  
Compression Bandaging ◽  
History Of ◽  
Artery Disease

Abstract Background and Purpose Lower extremity edema, which can be caused by several factors, is often poorly managed with commonly prescribed compression stockings and diuretics. Diuretics are often erroneously given in all forms of edema and may cause problems because their long-term application may induce chronicity of the edema due to disturbance of the renin-angiotensin relationship. Compression therapy, although effective against venous edema, is widely underused. Case Description A 64-year-old man with a history of hypertension, coronary artery disease, psoriasis, and multiple myeloma was admitted to the hospital for neutropenic fever, right lower extremity (RLE) cellulitis, bilateral lower extremity (BLE) weakness, RLE pain, and significant BLE edema. The patient was referred to a lymphedema-certified therapist to apply lower extremity multilayered compression bandaging and document serial limb circumference measurements. Outcomes The patient's weight decreased from 94.5 kg on day 1 of compression bandaging to 86.3 kg on day 7. The circumferences of the affected limbs also decreased. Discussion This case demonstrates the utility of multilayered compression bandaging, typically used in the management of lymphedema, in the control of peripheral edema that is refractory to diuretic therapy.

Standard Stripping versus Long Saphenous Vein-Saving Surgery for Primary Varicose Veins: A Prospective, Randomized Study with the Patients as Their Own Controls

1996 ◽  
Vol 11 (2) ◽  
pp. 45-49 ◽  
Author(s):  
M. Campanello ◽  
J. Hammarsten ◽  
C. Forsberg ◽  
P. Bernland ◽  
O. Henrikson ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Return ◽  
Varicose Veins ◽  
Return Time ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Saphenous Vein ◽  
Primary Varicose Veins ◽  
Postoperative Discomfort

Objective: To compare the postoperative discomfort and long-term outcome following standard stripping and atter long saphenous vein-saving surgery. Design: Prospective, randomized case-control study with patients serving as their own controls. Setting: Department of Surgery, County Hospital, Varberg, Sweden. Patients: Eighteen patients with bilateral primary varicose veins. Interventions: The patients were randomized prospectively to stripping or long saphenous vein-saving surgery. The leg causing most discomfort was operated on first. The other leg was operated on using the alternative method. Main outcome measures: Postoperative discomfort was assessed after an interview with the patient. Long-term outcome was determined by clinical assessment and Plethysmographic venous return time. Results: After 4 years the legs subjected to long saphenous vein-saving surgery yielded equal clinical results and had as great a prolongation of the plethysmographic venous return time as legs operated on using standard stripping. More patients reported greater discomfort following stripping than after vein-saving surgery. The saved long saphenous vein in all legs operated on was patent, compressible, non-sclerotic and free of intraluminal echoes. Conclusion: The long-term results of long saphenous vein-saving surgery are as good as standard stripping, provided that incompetent perforators are throughly mapped preoperatively and ligated at surgery. Long saphenous vein-saving surgery causes less subjective postoperative discomfort than standard stripping. The saved long saphenous vein can probably be used for future arterial reconstruction.

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