Preliminary Results of PTFE Patch Saphenoplasty to Prevent Neovascularization Leading to Recurrent Varicose Veins

Objective: Recurrence is common after varicose vein surgery. Neovascularization may be one cause of recurrent veins. This was a study of PTFE patch saphenoplasty to try and prevent recurrent veins. Design and setting: Prospective cohort study of patients treated in a vascular surgical unit. Patients and interventions: Fifty patients having surgery for symptomatic long saphenous varicose veins (66 legs, 51 primary and 15 recurrent veins) had a PTFE patch sutured over the saphenous opening after flush saphenofemoral ligation. Main outcome measures: The rate of varicose vein recurrence and neovascularization 1 year after surgery were determined using clinical examination and venous duplex imaging. Results: Forty patients (80%) remained pleased with the results of their surgery. Recurrent veins were visible in 14 (21%) legs: 10 were principally due to neovascularization, two to sapheno-popliteal incompetence and two to an incompetent mid-thigh perforating vein. Three other legs had neovascularization but no recurrent veins. Both recurrent veins (47% versus 14%) and neovascularization (40% versus 14%) were significantly more common in patients having surgery for recurrent veins. Conclusions: PTFE patching was safe but did not abolish neovascularization. Neovascularization was the principal cause of recurrent veins in this study and perseverance with investigations into other barrier methods is worthwhile.

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Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽

10.1055/s-0037-1622175 ◽

2007 ◽

Vol 36 (03) ◽

pp. 132-136

Author(s):

M. W. de Haan ◽

J. C. J. M. Veraart ◽

H. A. M. Neumann ◽

P. A. F. A. van Neer

Keyword(s):

Varicose Vein ◽

Varicose Veins ◽

Varicose Vein Surgery ◽

Proximal Point ◽

Perforating Veins ◽

Recurrent Varicose Veins ◽

Below The Knee ◽

Duplex Imaging ◽

Additional Value

SummaryThe objectives of this observational study were to investigate whether varicography has additional value to CFDI in clarifying the nature and source of recurrent varicose veins below the knee after varicose vein surgery and to investigate the possible role of incompetent perforating veins (IPV) in these recurrent varicose veins. Patients, material, methods: 24 limbs (21 patients) were included. All patients were assessed by a preoperative clinical examination and CFDI (colour flow duplex imaging). Re-evaluation (clinical and CFDI) was done two years after surgery and varicography was performed. Primary endpoint of the study was the varicographic pattern of these visible varicose veins. Secondary endpoint was the connection between these varicose veins and incompetent perforating veins. Results: In 18 limbs (75%) the varicose veins were part of a network, in six limbs (25%) the varicose vein appeared to be a solitary vein. In three limbs (12.5%) an incompetent sapheno-femoral junction was found on CFDI and on varicography in the same patients. In 10 limbs (41%) the varicose veins showed a connection with the persistent below knee GSV on varicography. In nine of these 10 limbs CFDI also showed reflux of this below knee GSV. In four limbs (16%) the varicose veins showed a connection with the small saphenous vein (SSV). In three limbs this reflux was dtected with CFDI after surgery. An IPV was found to be the proximal point of the varicose vein in six limbs (25%) and half of these IPV were detected with CFDI as well. Conclusion: Varicography has less value than CFDI in detecting the source of reflux in patients with recurrent varicose veins after surgery, except in a few cases where IPV are suspected to play a role and CFDI is unable to detect these IPV.

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Protocol for the Prospective Cohort Study for Varicose Veins Incidence and Natural Course (VINCI)

Flebologiia ◽

10.17116/flebo20211502174 ◽

2021 ◽

Vol 15 (2) ◽

pp. 74

Author(s):

I.A. Zolotukhin ◽

E.A. Ilyukhin ◽

S.A. Mirakhmedova ◽

I.A. Suchkov

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Varicose Veins ◽

Natural Course

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Development of Delirium: A Prospective Cohort Study in a Community Hospital

International Psychogeriatrics ◽

10.1017/s1041610200006244 ◽

2000 ◽

Vol 12 (1) ◽

pp. 117-127 ◽

Cited By ~ 43

Author(s):

Nancy J. Martin ◽

Michael J. Stones ◽

Janet E. Young ◽

Michel Bédard

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Community Hospital ◽

Acute Hospital ◽

Social Variables ◽

Process Of Care ◽

Patient Variables ◽

Surgical Unit

Background: Previous research on risk of delirium in acute hospital settings identified mainly patient variables (e.g., age) that are not amenable to intervention. The purpose of this study was to develop a model for new delirium in hospitalized older patients that included process of care and social variables. Methods: A prospective cohort study was undertaken in a community hospital in Ontario, Canada. Research paticipants included 156 hospitalized patients age 65+ years and without delirium on admission who were admitted to a medical or surgical unit. The measures included daily appraisal of delirium using a standardized and validated tool, and assessment of patient, process of care, and social variables. Results: Delirium developed in 28 of the 156 patients (17.9%). Older age and cognitive impairment were significant patient variables. Significant process of care variables included a high number of medications administered during hospitalization, surgery, a high number of procedures during early hospitalization (e.g., x-rays, blood tests), and intensive care treatment. Conclusions: Approximately one older patient in five developed delirium after admission to a medical or surgical unit. Risks not easily amenable to intervention included age, cognitive dysfunction, surgery, and intensive care requirements. Risk factors that are potentially modifiable included number of medications and number of procedures. Future research might focus on the efficacy of such intervention to reduce new-onset delirium in acute hospital settings.

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