Techniques of Sclerotherapy: A Method to Distend Leg Veins with the Patient in a Horizontal Position Prior to Needle Insertion

1993 ◽  
Vol 8 (1) ◽  
pp. 27-28 ◽  
Author(s):  
W. P. Bundens
Keyword(s):  
Prospective Study ◽  
Outcome Measures ◽  
Varicose Vein ◽  
San Diego ◽  
Outpatient Surgery ◽  
Varicose Veins ◽  
Needle Insertion ◽  
University Of California ◽  
Horizontal Position ◽  
La Jolla

Objective: To demonstrate the efficacy of the use of a large contoured thigh cuff to distend varicose veins, with the patient in a horizontal position, prior to needle insertion for sclerotherapy. Design: Prospective study in varicose vein patients treated by injection-compression sclerotherapy. Setting: Outpatient Surgery Clinic, University of California San Diego, La Jolla, California. Patients: Patients presenting with varicose veins on the lower thigh and below. Interventions: Patients underwent injection-compression sclerotherapy. Needles insertion was done with the patient in a horizontal position after veins were distended using a large contoured thigh cuff. Main outcome measures: Successful vein distension and needle insertion. Results: Ninety-five percent of patients had adequate vein distension for needle insertion. Conclusion: Vein distension, prior to needle insertion for sclerotherapy can be achieved by using a large contoured thigh cuff.

Neovascularization in Recurrent Sapheno-Femoral Incompetence of Varicose Veins: Surgical Anatomy and Morphology

1995 ◽  
Vol 10 (4) ◽  
pp. 136-142 ◽  
Author(s):  
G. M. Glass
Keyword(s):  
Prospective Study ◽  
Outcome Measures ◽  
Patient Group ◽  
Clinical Assessment ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Surgical Anatomy ◽  
Single Patient ◽  
Surgical Exploration

Objective: To investigate the surgical anatomy and morphology of recurrent sapheno-femoral incompetence after correctly performed sapheno-femoral ligation. To test the hypothesis that such recurrence develops through neovascularization. Design: Prospective study of single patient group. Setting: Varicose vein clinic of teaching hospital. Patients: One hundred and twenty-eight patients (141 limbs) were reviewed 4 or more years after accurately performed sapheno-femoral ligation with catgut, silk or tantalum wire. Intervention: Clinical assessment, phlebography, surgical exploration and examination of recurrent veins by radiographic and histological methods. Main outcome measures: Presence of reflux through newly formed veins at the site of previous ligation. Results: Of 141 limbs, clinical or phlebographic evidence of sapheno-femoral recurrence was confirmed in 35 of 37 on surgical exploration. The continuity of the saphenous vein with the previously ligated sapheno-femoral junction was restored through a newly formed vein or complex of veins. Conclusions: Neovascularization was the cause of recurrent sapheno-femoral incompetence after correctly performed sapheno-femoral ligation.

Prevention of Sapheno-Femoral and Sapheno-Popliteal Recurrence of Varicose Veins by Forming a Partition to Contain Neovascularization

1998 ◽  
Vol 13 (1) ◽  
pp. 3-9 ◽  
Author(s):  
G. M. Glass
Keyword(s):  
Effective Treatment ◽  
Outcome Measures ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Morphological Examination ◽  
Surgical Exploration ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: To test the hypothesis that sapheno-femoral recurrence of varicose veins may be prevented by containment of neovascularization. Design: Prospective minimum 4-year follow-up by surgical exploration and morphological examination of recurrent vessels in all limbs with clinical or phlebographic evidence of sapheno-femoral recurrence. Setting: Varicose vein clinic of a teaching hospital. Interventions: Sapheno-femoral ligation and multiple ligation (group 1); sapheno-femoral ligation, interposition of cribriform fascia and multiple ligation (group 2); sapheno-femoral ligation, interposition of artificial implant and stripping (group 3). Main outcome measures: Incidence of sapheno-femoral recurrence. Results: The incidence of sapheno-femoral recurrence through neovascularization was lower ( p < 0.001) in groups 2 and 3 after containment of neovascularization at the sapheno-femoral junction by cribriform fascia or artificial implant than in group 1 after ligation alone (3% and 1% vs 25%, respectively). The incidence of recurrent or persistent varices distal to the groin was lower ( p < 0.001) after stripping (group 3, 57%) than after multiple ligation (group 1, 93%; group 2, 81%). Conclusions: Sapheno-femoral ligation, interposition of cribriform fascia or artificial implant at the sapheno-femoral junction, and stripping is a more effective treatment of varicose veins than sapheno-femoral ligation and multiple ligation.

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