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The Medical Journal of Malaysia Aug 2008Chronic venous disorders range from telangiactasia or spider veins to varicose veins, venous swellings, skin changes and venous ulcerations. The aim of this study is to...
Chronic venous disorders range from telangiactasia or spider veins to varicose veins, venous swellings, skin changes and venous ulcerations. The aim of this study is to assess outcome of varicose vein surgery in the ethnically diverse population of Penang, Malaysia. This study is a retrospective analysis of patients seen from 1999 to 2004. All patients who presented to the outpatient clinic of our surgical department with saphenofemoral junction (SFJ) and/or saphenopopliteal junction (SPJ) reflux associated with incompetence of the great saphenous vein (GSV) or small saphenous vein (SSV) respectively underwent classical varicose varicose vein surgery. A single surgeon at a single institution performed the surgeries. Data from pre-operative, post-operative and follow-up procedures were recorded in case report forms. A total of 202 cases were treated. Of these, 200 were qualified by the inclusion criteria and follow-ups, with 23 who were treated bilaterally. Of those treated, Chinese comprised 47.5%, Indians 27.0%, Malays 12.5% and foreigners 13.0% (largely Indonesian Chinese, British and Americans). The average age was 52.1 years. Indians had the highest average BMI of 29.2, compared to the Chinese who had the lowest of 24.6. Based on occupation, housewives (43.0%), blue collar workers (19.0%), salespersons (12.0%) and factory workers (9.5%) were among those afflicted with varicose veins. While local Chinese predominated in the business groups (salespersons and food-related workers), the Indians and Malays in this study were mainly factory workers and/or blue collar workers. Symptomatology in descending order of severity included pain in 80.0% of cases, swelling in 65.5%, heaviness in 53.5%, cramps in 53.0%, lipodermatosclerosis in 39.0%, superficial thrombophlebitis in 33.5%, venous ulceration in 32.0%, eczema 22.0% and cellulitis in 12.5% of patients. Post surgery pains dropped to 9.9%, cramps 6.4%, heaviness 5.5% and swelling 5.3% (p<0.0001 in all groups). Indians had the highest rate of venous ulcers (35.2% of all Indians treated) possibly due to their high BMI and low socioeconomic background. In cases of venous ulcers, gram negative infections (49.8%) were more common than gram positive infections at 18.8%. Operative procedures performed included great saphenous vein high ligation in 96.5% of cases, stripping 93.5% and multiple avulsions in 98.5%, saphenous popliteal junction ligation with multiple avulsions in 13.0% and subfascial ligation in 10.5%. Operative complications included induration (40.0% of cases), bruising in 49.5%, pains in 15.0%, paraesthesia in 3.5%, wound infection in 4.0%, deep venous thrombosis in 3.0% and ulcer recurrence in 7.5%. A total of 96.2% of patients treated expressed satisfaction with varicose vein surgery. Late presentations of chronic venous insufficiency, possibly as a result of poor understanding and inadequate education on diet, weight control, use of stockings and change in lifestyle by patients, employers and general practitioners are probably the cause of high rates of severe chronic venous disease especially venous ulcerations in the local community. However, classical varicose vein surgery is widely applicable across diverse ethnicities with a high rate of success.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Ethnicity; Female; Humans; Malaysia; Male; Middle Aged; Retrospective Studies; Socioeconomic Factors; Treatment Outcome; Varicose Veins; Young Adult
PubMed: 19248688
DOI: No ID Found -
Der Hautarzt; Zeitschrift Fur... May 2005In Germany almost every third adult suffers from varicose veins requiring treatment. Conventional varicose vein surgery by high ligation and stripping is widely accepted... (Review)
Review
In Germany almost every third adult suffers from varicose veins requiring treatment. Conventional varicose vein surgery by high ligation and stripping is widely accepted as standard therapy for saphenous vein insufficiency, although associated with a high frequency of recurrent varicosities. Innovative endovascular procedures laying claim to be minimally invasive have been implemented over the last five years: endovenous radiofrequency obliteration, endovenous laser treatment and ultrasound-guided sclerotherapy with foam. The early treatment outcomes are promising in regard to recurrent varicose veins, cosmetic results and convalescence. Evidence-based prospective trials with large numbers of participants comparing the interventional procedures with high ligation and stripping are still missing. This report delineates current developments in varicose vein surgery and provides information on principles, effectiveness and side effect profiles of endovascular therapy procedures.
Topics: Catheter Ablation; Clinical Trials as Topic; Evidence-Based Medicine; Humans; Laser Therapy; Ligation; Minimally Invasive Surgical Procedures; Practice Guidelines as Topic; Practice Patterns, Physicians'; Sclerotherapy; Varicose Veins; Vascular Surgical Procedures; Venous Thrombosis
PubMed: 15887052
DOI: 10.1007/s00105-005-0931-8 -
European Journal of Vascular and... Dec 2013It has been suggested that the Aberdeen Varicose Vein Questionnaire (AVVQ) could be used to help inform a patient pathway for referral and treatment of varicose veins....
OBJECTIVES
It has been suggested that the Aberdeen Varicose Vein Questionnaire (AVVQ) could be used to help inform a patient pathway for referral and treatment of varicose veins. We aimed to determine 1) which patient and vein characteristics affected the AVVQ score, and 2) whether scores differed between those who were and were not offered treatment.
METHODS
Patients completed the AVVQ at the clinic prior to being seen. Treatment was offered to patients with symptoms, and duplex detected truncal incompetence by surgeons blinded to the score.
RESULTS
A total of 228 consecutive patients completed the AVVQ: 199 were valid questionnaires. On multivariate analysis, factors associated with a worse quality of life were female gender (p = .034, 3.14 mean unit increase in AVVQ), and bilateral varicose veins (10.25 unit increase, p < .001). For patients with C2 disease, only the presence of bilateral veins was significant. Overall, the AVVQ score was higher in those patients offered treatment than in those who were not (mean 20.3 [SD = 9.9] vs. 17.3 [SD = 10.3], p = .023), which equates to a 2.74 unit increase. This was not significant in patients with C2 disease.
CONCLUSION
It is unlikely that a threshold AVVQ score could be used to aid referral of patients with C2 disease. The distribution of veins (unilateral vs. bilateral) must be adjusted for when reporting AVVQ scores.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Multivariate Analysis; Quality of Life; Referral and Consultation; Severity of Illness Index; Sex Factors; Surveys and Questionnaires; Varicose Veins; Venous Insufficiency; Young Adult
PubMed: 24119467
DOI: 10.1016/j.ejvs.2013.08.019 -
Phlebology Dec 2021The Venablock Venous Closure System (Invamed, Ankara, Turkey) is a novel cyanoacrylate-based non-thermal non-tumescent embolization device to block refluxing truncal... (Clinical Trial)
Clinical Trial
BACKGROUND
The Venablock Venous Closure System (Invamed, Ankara, Turkey) is a novel cyanoacrylate-based non-thermal non-tumescent embolization device to block refluxing truncal veins for chronic venous insufficiency and varicose veins. The aim was to prospectively evaluate the safety and 6 months efficacy of Venablock for the treatment of primary great saphenous vein (GSV) and small saphenous vein (SSV) incompetency in a multi-ethnic cohort from Singapore.
METHODS
This was a single arm, single investigator prospective study of 29 patients (39 limbs, 39 truncal veins) recruited over a 5-month period (August 2019 to February 2020), who were treated with the Venablock device at a tertiary vascular unit in Singapore. Patients with symptomatic varicose veins (C2-6) and had truncal reflux > 0.5 second on venous Duplex ultrasound were included. Follow-up occurred at 2 weeks, 3 and 6 months with dedicated quality of life questionnaires and a targeted Duplex ultrasound performed to check for continued venous occlusion.
RESULT
Mean age was 61.4 (±11.0) years and mean BMI was 26.2 (±5.7) kg/m. 11/29 (37.9%) were males. Most common CEAP class treated was 2 (12/29, 41.3%). Mean diameter of treated GSV was 5.7 (±2.0) mm, 4.8 (±1.7) mm and 4.2 (±1.3) mm for the proximal, mid and distal above knee segments respectively. Mean time from access puncture to sheath removal was 23.4 (±10.0) mins. Vein occlusion at 2 weeks, 3 and 6 months was 39/39 (100%), 39/39 (100%) and 36/37 (97.2%) respectively. 5/29 (17.2%) developed puncture site infections, of which 3/29 (7.7%) required formal surgical drainage. 3/29 (7.7%) developed phlebitis. At 6 months, revised Venous Clinical Severity Score improved from 5.2 (±3.5) to 2.1 (±2.9; p < .001); EuroQol-5 Dimension score, from 7.4 (±2.1) to 5.7 (±1.4; p < .001); Aberdeen Varicose Vein Questionnaire score, from 18.1 (±15.5) to 7.9 (±8.9; p = .007); and Chronic Venous Insufficiency Questionnaire, from 18.6 (±16.2) to 4.5 (±6.3; p < .001).
CONCLUSION
Venablock is a safe and efficacious option of treating truncal venous insufficiency in a multi-ethnic Asian cohort from Singapore in the short term. There is a significant improvement in QoL. Longer follow-up is required to assess the durability of this technique, in particular the higher puncture site infection rates observed compared to other glue-based therapies.
Topics: Humans; Male; Middle Aged; Prospective Studies; Quality of Life; Registries; Saphenous Vein; Singapore; Treatment Outcome; Varicose Veins; Venous Insufficiency
PubMed: 34152882
DOI: 10.1177/02683555211025181 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2020The aim: With the help of biochemical and morphological methods of investigation to identify the causes of a false postoperative recurrence of varicose veins after the...
OBJECTIVE
The aim: With the help of biochemical and morphological methods of investigation to identify the causes of a false postoperative recurrence of varicose veins after the EVLC.
PATIENTS AND METHODS
Materials and methods: In 173 patients with varicose veins of the lower extremities, the level of markers of endothelial dysfunction was determined: P-selectin, E-selectin, tissue plasminogen activator, endothelin-1, adhesion molecules of type 1 vascular endothelium (sVCAM-1-soluble vascularcellularmolecula), circulating endothelial cells (CEC) before surgery (EVLC), on the 10th and 60th day of the postoperative period.At the same time, a morphological and electron microscopic examination of the state of the deep venous system in 31 patients with varicose vein disease of the lower extremities who died from acute heart failure, was performed.
RESULTS
Results: Increased values of markers of endothelial dysfunction in patients with varicose veins of the lower extremitiesbefore surgery of EVLC were established. We found that, despite the operation, the parameters of endothelial dysfunction decrease, but in the remote postoperative period do not come to the norm. Morphological and electron microscopic studies of the deep vein wall revealed pathomorphological changes in all of their layers, especially the endothelial layer. At the heart of the development of endothelial dysfunction in the postoperative period, the leading role belongs to changes in mitochondria.
CONCLUSION
Conclusions: 1. Based on our research, we can state that there are significant pathomorphological and pathophysiological changes in the deep venous system of the lower extremities in conditions of varicose vein disease. 2. The initiator of postoperative relapse of varicose veins are structural changes in the wall of deep veins with a violation of the integrity of the endothelial lining, contributing to the absorption of plasma and leukocyte contents from the blood stream in the interstitium, with the following pathological changes in the layers of deep veins.Such changes are the basis for the manifestations of endothelial dysfunction in the postoperative period.
Topics: Endothelial Cells; Humans; Lasers; Recurrence; Tissue Plasminogen Activator; Varicose Veins
PubMed: 33454685
DOI: No ID Found -
The Medical Journal of Australia Jul 1970
Topics: Adult; Female; Humans; Inguinal Canal; Ligaments; Male; Postoperative Complications; Pregnancy; Varicose Veins
PubMed: 5455771
DOI: 10.5694/j.1326-5377.1970.tb87377.x -
Seminars in Cutaneous Medicine and... Dec 2005Successful varicose vein surgery depends on accurate preoperative assessment and individualized treatment for various combinations of venous insufficiency. Noninvasive... (Review)
Review
Successful varicose vein surgery depends on accurate preoperative assessment and individualized treatment for various combinations of venous insufficiency. Noninvasive duplex scanning is currently the gold standard in varicose vein evaluation. Flush ligation and division of the great saphenous vein and its tributaries, inverted downward stripping to below the knee combined with stab avulsion of varicosities, have yielded excellent results for patients with great saphenous vein reflux. Additionally, identifying and correcting incompetent calf perforating veins is necessary to achieve a satisfactory outcome. Neovascularization at the saphenofemoral junction and varicose vein recurrence and their treatment remain unsolved and require further investigation.
Topics: Humans; Ligation; Recurrence; Saphenous Vein; Trauma, Nervous System; Varicose Veins; Vascular Surgical Procedures
PubMed: 16387264
DOI: 10.1016/j.sder.2005.10.004 -
JNMA; Journal of the Nepal Medical... Mar 2021Varicosity is the common problem of various etiology having simple limb aching to worst complications like oedema, ulcer, and skin changes. Minimal invasive endovenous...
INTRODUCTION
Varicosity is the common problem of various etiology having simple limb aching to worst complications like oedema, ulcer, and skin changes. Minimal invasive endovenous laser therapy is a noble procedure. The aim of the study is to find out the recurrence of the varicose vein after laser therapy in a tertiary care center.
METHODS
This descriptive cross-sectional study was done in 38 patients with varicosity of the lower limb in a tertiary care hospital, from January 2019 to June 2019 after taking ethical clearance from Institutional Review Committee. Convenience sampling was done. Data was collected and entry was done in Statistical Package for the Social Science software version 22, point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data.
RESULTS
We recorded 38 patients with ablated limb out of which none of the ablated veins showed recanalization in six months follow up. Twenty two (58%) patients were male and 16 (42%) patients were female with a mean age of 40.26 years. Major bulk, 23 (60.5%) resumed activity in second postoperative day and only 1 (2.6%) patient waited for 5 days for normal activity with mean of 2.58 days postoperatively. Sixteen (42.1%) patients developed erythema or ecchymosis, 12 (31.6%) patients had induration along the long saphenous vein course, 7 (18.4%) patients had paresthesia, 2 (5.3%) patients had limb swelling and 1 (2.6%) patient had skin burn.
CONCLUSIONS
Endovenous laser ablation has very low rate of recurrence of varicosity and has minor complications.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Laser Therapy; Male; Recurrence; Saphenous Vein; Tertiary Care Centers; Treatment Outcome; Varicose Veins
PubMed: 34506441
DOI: 10.31729/jnma.6163 -
Phlebology Feb 2009A surgical care practitioner (SCP) completed a structured training programme to perform all aspects of varicose vein surgery including sapheno-femoral disconnection and...
A surgical care practitioner (SCP) completed a structured training programme to perform all aspects of varicose vein surgery including sapheno-femoral disconnection and long saphenous vein stripping. Over a four-year period, she performed 152 groin procedures, closed 191 groin wounds and undertook phlebectomies on 91 legs with excellent results. A SCP can be used to improve theatre utilization and efficiency with no obvious drawbacks.
Topics: Competency-Based Education; Education, Nursing, Graduate; Humans; Nurse Clinicians; Nursing Evaluation Research; Operating Room Nursing; Varicose Veins; Vascular Surgical Procedures
PubMed: 19155341
DOI: 10.1258/phleb.2008.008023 -
VASA. Zeitschrift Fur Gefasskrankheiten Sep 2011This 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... (Review)
Review
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.
Topics: Endovascular Procedures; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Patient Selection; Recurrence; Risk Assessment; Sclerotherapy; Treatment Outcome; Varicose Veins; Vascular Surgical Procedures
PubMed: 21948777
DOI: 10.1024/0301-1526/a000131