Does the number of pregnancies affect patterns of great saphenous vein reflux in women with varicose veins?

2010 ◽  
Vol 25 (4) ◽  
pp. 190-195 ◽  
Author(s):  
C A Engelhorn ◽  
M F Cassou ◽  
A L Engelhorn ◽  
S X Salles-Cunha
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasonography ◽  
Skin Changes ◽  
Colour Flow ◽  
Primary Varicose Veins ◽  
Saphenofemoral Junction ◽  
Vein Reflux

Objectives Impact of pregnancies on great saphenous vein (GSV) reflux patterns deserves clarification. Which GSV segment is most affected? Is the saphenofemoral junction (SFJ) involved? Methods Colour-flow duplex ultrasonography was performed in 583 women extremities with primary varicose veins (clinical, aetiological, anatomical and pathological elements [CEAP C2]), without oedema, skin changes or ulcer. Women with previous thrombosis or varicose surgery were excluded. GSV reflux sources and drainage points were located at SFJ, thigh, knee and calf. Prevalence of most proximal reflux source was noted as a function of 0, 1, 2, 3 and 4 or more pregnancies. χ2 statistics was employed. Results Prevalence of GSV reflux was not dependent on 0, 1, 2, 3 or ≥4 pregnancies: 75%, 69%, 79%, 70% and 76% for right leg ( P = 0.79) and 78%, 81%, 82%, 79% and 73% for left leg ( P = 0.87), respectively. Prevalence of SFJ reflux and GSV reflux, starting at the thigh, knee or calf, was similar and showed no tendencies to increase with number of pregnancies. Conclusions Number of pregnancies did not influence GSV reflux patterns in women with primary varicose veins.

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.

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.

CHIVA treatment of saphenous vein insufficiency with aneurysm of the great saphenous vein in von Willebrand’s disease

Phlebologie ◽  
2016 ◽  
Vol 45 (06) ◽  
pp. 371-374
Author(s):  
E. Mendoza
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Von Willebrand's Disease ◽  
Skin Changes ◽  
Von Willebrand’S Disease ◽  
Below The Knee ◽  
A Minor ◽  
Saphenofemoral Junction ◽  
Minor Procedure

SummaryIn patients with an increased tendency to bleeding and severe varicose veins, even the minimally invasive venous procedure CHIVA requires careful planning and risk assessment. CHIVA treatment is reported in a 67-year-old female patient with aneurysm of the great saphenous vein at the saphenofemoral junction, reflux above and below the knee (Hach III), skin changes (C4a) and von Willebrand’s disease. Radiofrequency was used over a 13 cm segment in the proximal great saphenous vein. The result shows a reduction in the diameter of the great saphenous vein at the thigh from 8.2 to 5.4 mm and an absence of reflux and absence of clinic. Even in patients with severe findings, a minor procedure can achieve a good clinical result with low risk.

A study to evaluate patterns of superficial venous reflux in patients with primary chronic venous disease

2014 ◽  
Vol 30 (7) ◽  
pp. 455-461 ◽  
Author(s):  
Mahim I Qureshi ◽  
Manj Gohel ◽  
Louise Wing ◽  
Andrew MacDonald ◽  
Chung S Lim ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Chronic Venous Disease ◽  
Duplex Ultrasonography ◽  
Venous Disease ◽  
Venous Reflux ◽  
History Of ◽  
Primary Chronic Venous Disease ◽  
Saphenofemoral Junction ◽  
Vein Reflux

Objective This study assessed patterns of superficial reflux in patients with primary chronic venous disease. Methods Retrospective review of all patient venous duplex ultrasonography reports at one institution between 2000 and 2009. Legs with secondary, deep or no superficial reflux were excluded. Results In total, 8654 limbs were scanned; 2559 legs from 2053 patients (mean age 52.3 years) were included for analysis. Great saphenous vein reflux predominated (68%), followed by combined great saphenous vein/small saphenous vein reflux (20%) and small saphenous vein reflux (7%). The majority of legs with competent saphenofemoral junction had below-knee great saphenous vein reflux (53%); incompetent saphenofemoral junction was associated with combined above and below-knee great saphenous vein reflux (72%). Isolated small saphenous vein reflux was associated with saphenopopliteal junction incompetence (61%), although the majority of all small saphenous vein reflux limbs had a competent saphenopopliteal junction (57%). Conclusion Superficial venous reflux does not necessarily originate from a saphenous junction. Large prospective studies with interval duplex ultrasonography are required to unravel the natural history of primary chronic venous disease.

scholarly journals Initial patterns of unilateral great saphenous vein reflux in women with telangiectasias and varicose veins

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Carlos A. Engelhorn ◽  
Ana Luiza D.V. Engelhorn ◽  
Sergio X. Salles-Cunha ◽  
Patricia R. Terna ◽  
Karine D. Kovalski ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
T Test ◽  
Chi Square ◽  
Saphenofemoral Junction ◽  
Paired T Test ◽  
Valvular Insufficiency ◽  
Vein Reflux

Telangiectasias and varicose veins have been linked to chronic venous valvular insufficiency causing great saphenous vein (GSV) reflux. GSV diameter-reflux correlations were determined in women C1 and/or C2 and unilateral GSV reflux. Subgroups were: i) bilateral C1/C1 (n=106) and ii) refluxing <em>GSV</em> C2/contralateral nonrefluxing C1 or C2 (n=50). <em>GSV</em> included saphenofemoral junction (SFJ), GSV, and major veins in and out of the saphenous compartment at knee and calf. Prevalence and diameters were compared by Chi-square and paired t-test. Reflux prevalence at junction, thigh and calf were 5%, 26% and 71% of 106 refluxing C1 extremities, and 18%, 44% and 72% of 50 refluxing C2 extremities (P=0.007, 0.03, 0.87). Significant diameter increase compared to contralateral nonrefluxing segment (P&lt;0.05) were at: C2 junction, 7.9±1.8 <em>vs</em> 6.6±1.5 mm, and C2 mid-thigh, junction refluxing or not, 4.8±1.1 <em>vs</em> 3.6±1.0 or 4.1±0.8 <em>vs</em> 3.6±0.7 mm. Calf GSV diameters averaged 2.5 to 2.7 mm if reflux was below-knee. Unilateral reflux occurred in calf veins without correlation to diameter. Enlarged diameters were noted in refluxing SFJ and thigh GSV of women with varicose veins.

Bilateral iliac vein stenting reduces great and small saphenous venous reflux

Vascular ◽  
2019 ◽  
Vol 27 (6) ◽  
pp. 623-627 ◽  
Author(s):  
Jesse Chait ◽  
Pavel Kibrik ◽  
Kevin Kenney ◽  
Ahmad Alsheekh ◽  
Yuriy Ostrozhynskyy ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Iliac Vein ◽  
Duplex Ultrasonography ◽  
Venous Reflux ◽  
Vascular Intervention ◽  
Left And Right ◽  
Vein Disease ◽  
Time Of Intervention ◽  
Vein Reflux

Objective Iliac vein stenting has been an evolving treatment option in the management of CVI secondary to iliac vein obstruction. Historically, treatment of CVI has been focused on the elimination of saphenous vein disease; however, the effect of reduction of iliac vein obstruction on superficial venous reflux remains largely unknown. This study aimed to identify the effect of iliac vein stenting on saphenous vein reflux. Methods In this retrospective study spanning course of five years, we performed 2681 venograms with venoplasties and stenting of the iliac veins. Pre-operative and post-operative venous mapping was performed via duplex ultrasonography. Patients who received any lower extremity vascular intervention between “pre-” and “post-stenting” duplex ultrasonography examination, other than iliac vein stenting, were excluded from analysis. Results One thousand six hundred forty-five patients, of which 63.2% were female, underwent iliac vein stenting; 1033 patients received bilateral intervention, whereas 356 and 259 patients received unilateral left and right stenting, respectively. The average age of the patient cohort was 66 (range 22–100; SD ± 13.9). The distribution CEAP scores of each limb at the time of intervention were: C2 (1%), C3 (25%), C4 (51%), C5 (5%), and C6 (18%). Bilateral iliac vein stenting significantly reduced reflux in the bilateral great saphenous and small saphenous veins by 363.8 ms ( p < 0.0001) and 345.4 ms ( p < 0.0002), respectively, but had no effect on ASV reflux. Unilateral stenting did not produce significant reductions in reflux, besides an average reduction of 573.2 ms ( p = 0.004) in the left great saphenous vein. Conclusion Bilateral iliac vein stenting decreased great saphenous vein and small saphenous vein reflux. Unilateral stenting did not demonstrate a significant reduction in saphenous reflux. Bilateral reduction in stenosis of the iliac veins may influence superficial venous reflux.

The Elastic Properties of the Human Great Saphenous Vein in Relation to Primary Varicose Veins

1974 ◽  
Vol 52 (2) ◽  
pp. 153-157 ◽  
Author(s):  
J. Kenneth Booking ◽  
Margot R. Roach
Keyword(s):  
Elastic Properties ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Simultaneous Measurements ◽  
Saphenous Veins ◽  
Before And After ◽  
Laplace’S Law ◽  
Primary Varicose Veins ◽  
Laplace's Law

Simultaneous measurements of pressure and volume were made on nine great saphenous veins obtained at autopsies and nine great saphenous veins that were stripped during surgery from patients with primary varicose veins. Similar measurements were also made on six great saphenous veins obtained at autopsy before and after they were held at 100 cm H2O for 4 h. Circumferential tensions were calculated from Laplace's law (tension = pressure × radius).The great saphenous veins from patients with primary varicose veins had significantly greater radii and were more distensible than the normal great saphenous veins. After being held at 100 cm H2O for 4 h, the normal great saphenous veins became less distensible and their radii at distending pressures increased.Due to the great difference in radii, the circumferential tension on a great saphenous vein from a patient with primary varicose veins is much greater than that on a normal great saphenous vein at the same distending pressure. However, the physical stresses exerted on the great saphenous veins during the stripping operations may influence our results in some unknown way.

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.

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