scholarly journals Use of a Novel Device in Reconstructive Venous Surgery: Preliminary Results

2020 ◽  
Vol 29 (04) ◽  
pp. 245-249
Author(s):  
Daniele Camilli ◽  
Alessandro Platone ◽  
Massimo Ruggeri ◽  
Sergio Furgiuele
Keyword(s):  
Venous Thrombosis ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
External Support ◽  
Long Term Results ◽  
Novel Device ◽  
Venous Surgery ◽  
Varicose Disease ◽  
Superficial Venous Insufficiency ◽  
External Valvuloplasty

AbstractEvaluation of the outcomes of OSES (oval-shaped external support), a novel device for external valvuloplasty of the great saphenous vein (GSV) for the conservative treatment of superficial venous insufficiency. Between 2012 and 2015, 30 patients underwent external valvuloplasty of the GSV for a total of 32 limbs. Patients were subjected to clinical and instrumental follow-up by a half-year ultrasound for a minimum of 36 months. The main endpoints were the recurrence of varicose disease, persistent or recurrent venous reflux, and venous thrombosis. Varicose recurrence was verified in six limbs on 32 (18.75%). Four limbs (12.5%) presented a recurrence of the reflux even in the absence of varicose veins. Two limbs (6.25%) underwent saphenectomy after the valvuloplasty intervention at 12 and 18 months, respectively, because of the presence of saphenofemoral reflux and varicose recurrences. No case of venous thrombosis of the saphenous trunk was observed. The external valvuloplasty of the GSV is a well-known technique that used to treat the superficial venous insufficiency. The newly introduced OSES device seems to show better midterm results, due to a better alignment of the valve flaps. In our experience, the use of this device gives better long-term results and allowed to extend the indication to patients with saphenic diameters that were considered not eligible for repair. In conclusion, although our data needs further confirmation, OSES device might represents a new interesting opportunity for reconstructive venous surgery.

Prevalence and management of ovarian venous insufficiency in the presence of leg venous insufficiency

2007 ◽  
Vol 22 (1) ◽  
pp. 29-33 ◽  
Author(s):  
R Sutaria ◽  
A Subramanian ◽  
B Burns ◽  
H Hafez
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Vena Cava ◽  
Vascular Surgeon ◽  
Venous Surgery ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Superficial Venous Insufficiency

Objective: The correlation between ovarian venous insufficiency and lower limb venous insufficiency remains poorly understood. Clinically, incompetent ovarian veins in association with lower extremity varicose veins are suspected when leg varicose veins are found in atypical distributions. Such distributions include upper lateral or posterior thigh, on the buttocks, crossing the inguinal ligament, and also in the vulval or perineal regions. The aim of this study was to determine the prevalence of ovarian venous insufficiency in those with clinically suspicious varicose veins, and to assess the effectiveness of ovarian venous embolization/ligation in treating this condition. Methods: Between June 2001 and December 2004, 424 female patients with lower limb superficial venous insufficiency were seen by a single vascular surgeon. These patients were clinically assessed, and those with atypical varicose veins were investigated with venous duplex examination and magnetic resonance imaging (MRI) venography. Patients with proven ovarian venous insufficiency were offered venography with a view to embolization or laparoscopic ligation. Results: A total of seven patients were clinically suspected of having ovarian venous insufficiency, of which three had recurrent varicose veins (42.9%). Of these, six were confirmed on MRI venography with the left side being more affected than the right; one of them had an occluded vena cava, three were treated by embolization, and two had laparoscopic ligation. Discussion: The prevalence of clinically detectable ovarian venous insufficiency in association with lower extremity varicose veins is in the region of 1.65%. Compared with the estimated prevalence of incidental ovarian venous insufficiency of 10–47%, this suggests that only a minority of incompetent ovarian veins will present with clinically detectable lower limb venous insufficiency. In our opinion, patients with signs suggestive of ovarian venous insufficiency in association with lower limb venous insufficiency should have their ovarian insufficiency controlled prior to embarking on limb venous surgery.

scholarly journals Superficial venous insufficiency from the infernal to the endothermal

2014 ◽  
Vol 96 (1) ◽  
pp. 5-10 ◽  
Author(s):  
D Carradice
Keyword(s):  
Gold Standard ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Resource Limitation ◽  
Skin Damage ◽  
The Common ◽  
Modern Treatment ◽  
The Cost ◽  
Superficial Venous Insufficiency

This review presents the common diseases associated with superficial venous insufficiency of the leg. These include varicose veins, swelling, skin damage and ulceration. The benefits and rationale behind treatment are discussed, followed by the historical advances from ancient mortality and prayer to the modern endovenous revolution. Finally, an overview of modern treatment options will discuss the evidence supporting the gold standard of endothermal ablation and the cost effectiveness of treatment at this time of challenging resource limitation.

Anatomical Patterns in Varicose Vein Disease: A Duplex Scanning Study

1995 ◽  
Vol 10 (3) ◽  
pp. 94-97 ◽  
Author(s):  
J. J. Guex ◽  
B. Hiltbrand ◽  
J. M. Bayon ◽  
F. Henri ◽  
F. A. Allaert ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Previous Treatment ◽  
Lower Limbs ◽  
Duplex Scanning ◽  
Consecutive Series ◽  
Yield Data ◽  
Varicose Disease ◽  
Vein Disease

Objectives: To determine symptomatology, clinical class, and topographic patterns of varicose veins in a consecutive series of patients with venous complaints. Methods: We performed clinical examination and duplex scanning of 498 lower limbs in 317 patients with obvious varicose veins for whom no previous treatment had been undertaken. Results: Classes of chronic venous insufficiency (CVI) in 498 legs: grade 0: 117 (23.5%); gr 1: 310 (62.2%); gr 2: 47 (9.4%); gr 3: 24 (4.8%). Duplex-detected venous reflux was found in the greater saphenous vein territory (junction or trunk or related perforator or main tributary) in 423 limbs (85.3%) the sapheno-femoral junction was incompetent in only 342 legs (68.7%). Reflux was found in the lesser saphenous vein territory in 100 limbs (20.1%) and in sapheno-popliteal junction in 92 (18.5%). Strictly non saphenous origin of varicosities was found in 31 limbs (6.2%). Deep venous incompetence was found in 48 legs (9.6%). Conclusions: These findings yield data on the distribution and occurence of lower limbs venous lesions in patients with varicose disease.

scholarly journals A GENETIC STUDY OF PATIENTS WITH CHRONIC VENOUS INSUFFICIENCY BASED ON CLINICAL AND GENEALOGICAL METHOD

2018 ◽  
Vol 14 (1-2) ◽  
pp. 59-63
Author(s):  
Kh.O. Korolova ◽  
V.V. Teplyi
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Autosomal Dominant ◽  
Varicose Veins ◽  
Hereditary Disease ◽  
Dominant Type ◽  
The Family ◽  
Varicose Disease ◽  
Disease Inheritance ◽  
Autosomal Dominant Type

Relevance. Practically 10-15 % of the world's population has varicose veins as a manifestation of chronic venous insufficiency. The clinical and genealogical method is the method allows to identify family cases of disease in patients with chronic venous insufficiency. Objective: to demonstrate the role of heredity in varicose disease, to analyze family cases of varicose disease, to determine the type of disease inheritance and to give a prediction of heredity for descendants, using the clinical and genealogical method. Materials and methods. The study involved 72 patients, mostly women – 46 (63.9 %) persons, with different classes of varicose veins according to the CEAP classification. To determine the type of inheritance we used clinical and genealogical method of pedigrees’ study. The nature of the trait – hereditary or non-hereditary disease; type of the inheritance – autosomal-dominant, autosomal-recessive, sex-linked, were defined. Results. The family nature of the varicose disease was revealed in 17 (23 %) of the 72 examined patients. The autosomal-dominant type of inheritance was determined. There is direct inheritance across generations. Conclusions. We determined the family nature of the disease inheritance, with the autosomal-dominant type of inheritance with a high degree of gene expression. In these families there is a high risk of the birth of the children who will have chronic venous insufficiency.

scholarly journals ENDOVENOUS LAZER COAGULATION: LONG-TERM RESULT - CRITERION OF TRUTH

2018 ◽  
Vol 3 (4) ◽  
pp. 27-30
Author(s):  
A G Shalashov ◽  
A V Kazantsev
Keyword(s):  
Varicose Veins ◽  
Intraoperative Complications ◽  
Lower Limbs ◽  
Long Term Results ◽  
Laser Coagulation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Result ◽  
Varicose Disease

Objectives - to study the long-term results of endovenous laser coagulation in patients with varicose veins of the lower extremities. Material and methods. The study included 241 patients with varicose disease of the lower limbs veins, who underwent surgical treatment using the method of endovenous laser coagulation. Results. The technical success of the operation was achieved in all cases, which was confirmed by color duplex scanning. There were no intraoperative complications. Long-term outcome was studied in 174 (72.2%) patients in the period up to 5 years. During the follow-up period the GSV occlusion signs were detected in 168 (96.4%) patients, partial recanalization of the GSV was registered in 6 (3.5%) patients.

Compression regimes after endovenous ablation for superficial venous insufficiency – A survey of members of the Vascular Society of Great Britain and Ireland

2015 ◽  
Vol 31 (1) ◽  
pp. 16-22 ◽  
Author(s):  
J El-Sheikha ◽  
S Nandhra ◽  
D Carradice ◽  
C Acey ◽  
GE Smith ◽  
...  
Keyword(s):  
Great Britain ◽  
Venous Insufficiency ◽  
Current Practice ◽  
Varicose Veins ◽  
Postal Questionnaire ◽  
Compression Stockings ◽  
Foam Sclerotherapy ◽  
Endovenous Laser Ablation ◽  
Endovenous Ablation ◽  
Superficial Venous Insufficiency

Introduction The optimal compression regime following ultrasound guided foam sclerotherapy (UGFS), radiofrequency ablation (RFA) and endovenous laser ablation (EVLA) for varicose veins is not known. The aim of this study was to document current practice. Methods Postal questionnaire sent to 348 consultant members of the Vascular Society of Great Britain and Ireland. Results Valid replies were received from 41% ( n = 141) surgeons representing at least 68 (61%) vascular units. UGFS was used by 74% surgeons, RFA by 70% and EVLA by 32%, but fewer patients received UGFS (median 30) annually, than endothermal treatment (median 50) – P = 0.019. All surgeons prescribed compression: following UGFS for median seven days (range two days to three months) and after endothermal ablation for 10 days (range two days to six weeks) – P = 0.298. Seven different combinations of bandages, pads and compression stockings were reported following UGFS and four after endothermal ablation. Some surgeons advised changing from bandages to stockings from five days (range 1–14) after UGFS. Following endothermal ablation, 71% used bandages only, followed by compression stockings after two days (range 1–14). The majority of surgeons (87%) also treated varicose tributaries: 65% used phlebectomy, the majority (65%) synchronously with endothermal ablation. Concordance of compression regimes between surgeons within vascular units was uncommon. Only seven units using UGFS and six units using endothermal ablation had consistent compression regimes. Conclusion Compression regimes after treatments for varicose veins vary significantly: more evidence is needed to guide practice.

Relationships between duplex findings and quality of life in long-term follow-up of patients treated for chronic venous disease

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 88-98 ◽  
Author(s):  
Ying Huang ◽  
Peter Gloviczki
Keyword(s):  
Quality Of Life ◽  
Clinical Studies ◽  
Varicose Veins ◽  
Long Term Results ◽  
Venous Disease ◽  
Venous Surgery ◽  
Long Term Follow Up

Objective Relationships between duplex findings and data on health-related quality of life (QoL) to assess long-term results of treatment of varicose veins and chronic venous insufficiency (CVI) are not well known. The goal of this review was to correlate duplex findings and QoL assessments in clinical studies with long-term follow-up. Methods A review of the English language literature on PUBMED revealed 17 clinical studies, including 9 randomized controlled trials (RCTs), 6 prospective, and 2 retrospective studies that included patients with at least 5-year follow-up after endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), and traditional superficial venous surgery. Results At 5 years, great saphenous vein (GSV) occlusion rate on duplex ultrasound ranged from 66% to 82% for EVLA, from 62% to 92% for RFA, from 41% to 58% for UGFS and from 54% to 85% for surgery. Freedom from GSV reflux rates were 82% and 84%, respectively for EVLA and surgery, and ranged between 84% and 95% for RFA. Significant improvements were observed in several domains of generic QoL and in most domains of venous disease-specific QoL, irrespective of the treatment. In at least one RCT, CIVIQ scores correlated well with abnormal duplex findings in patients who underwent treatment with UGFS. In another RCT, long-term AVVQ was significantly better after surgery as compared with UGFS similar to results of duplex findings. Conclusions Analysis of the available literature confirmed that all four techniques were effective in the abolishment of reflux or obliteration of the GSV. Moreover, well-designed RCTs with large sample size are needed to produce robust long-term data on clinical outcome after treatment of varicose veins and CVI and to better understand the relationships between duplex-derived data and QoL assessments.

scholarly journals A GENETIC STUDY OF PATIENTS WITH CHRONIC VENOUS INSUFFICIENCY BASED ON CLINICAL AND GENEALOGICAL METHOD

2018 ◽  
Vol 14 (1-2) ◽  
pp. 59-63
Author(s):  
Kh.O. Korolova ◽  
V.V. Teplyi
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Autosomal Dominant ◽  
Varicose Veins ◽  
Hereditary Disease ◽  
Dominant Type ◽  
The Family ◽  
Varicose Disease ◽  
Disease Inheritance ◽  
Autosomal Dominant Type

Relevance. Practically 10-15 % of the world's population has varicose veins as a manifestation of chronic venous insufficiency. The clinical and genealogical method is the method allows to identify family cases of disease in patients with chronic venous insufficiency. Objective: to demonstrate the role of heredity in varicose disease, to analyze family cases of varicose disease, to determine the type of disease inheritance and to give a prediction of heredity for descendants, using the clinical and genealogical method. Materials and methods. The study involved 72 patients, mostly women – 46 (63.9 %) persons, with different classes of varicose veins according to the CEAP classification. To determine the type of inheritance we used clinical and genealogical method of pedigrees’ study. The nature of the trait – hereditary or non-hereditary disease; type of the inheritance – autosomal-dominant, autosomal-recessive, sex-linked, were defined. Results. The family nature of the varicose disease was revealed in 17 (23 %) of the 72 examined patients. The autosomal-dominant type of inheritance was determined. There is direct inheritance across generations. Conclusions. We determined the family nature of the disease inheritance, with the autosomal-dominant type of inheritance with a high degree of gene expression. In these families there is a high risk of the birth of the children who will have chronic venous insufficiency.

Non-Thrombotic Deep Venous Incompetence with Special Reference to Anatomic, Haemodynamic and Therapeutic Aspects

1990 ◽  
Vol 5 (4) ◽  
pp. 255-270 ◽  
Author(s):  
Bo Almgren
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Venous Pressure ◽  
Long Term Results ◽  
Superficial Femoral Vein ◽  
Calf Muscle Pump ◽  
Asymptomatic Patients ◽  
High Incidence

This investigation was undertaken to study non-thrombotic deep venous insufficiency (DVI) in patients with varicose veins or other venous symptoms. Deep venous reflux was observed in 3.5% of the ‘normal’ limbs in patients with unilateral varicose veins. A high incidence of reflux was found in limbs with untreated (21%, P < 0.001) and with recurrent varicose veins (43%, P < 0.001) compared with that in ‘normal’ limbs. Among patients with non-thrombotic DVI the most common patterns were isolated reflux in the superficial femoral vein (51%), and combined reflux in the superficial and deep femoral veins (44%). Isolated reflux in the deep femoral vein occured in 5%. Complete visualization of the deep femoral vein is a new diagnostic sign that strongly correlates ( P < 0.001) with reflux in this vein. femoropopliteal and isolated popliteal reflux caused abnormal venous pressure values even in asymptomatic patients. Incompetence of calf perforators strongly influenced these values. Varicose vein surgery in limbs with a strong calf muscle pump resulted in significant improvement in venous pressure. The long-term results of valvuloplasty were good in 67% of the extremities. A significant improvement in venous pressure was observed in limbs with competent deep femoral vein valves, which suggests that the functional state of this vein is of great haemodynamic importance.

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