scholarly journals Crossectomy and Foam Sclerotherapy of the Great Saphenous Vein versus Stripping of Great Saphenous Vein and Varicectomy in the Treatment of the Legs Ulcers

Ulcers ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Alvaro Delgado-Beltran
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Average Rate ◽  
Healing Time ◽  
Foam Sclerotherapy ◽  
Group I ◽  
Incomplete Healing ◽  
Invasive Method ◽  
Group Ii

Objective. To show our results in the surgical treatment of legs varicose ulcers, with crossectomy and foam sclerotherapy (CAFE) of the great saphenous vein (GSV) in group I and stripping of GSV and varicectomy in group II. Methods. 35 patients with active venous leg ulcers were recruited and treated. They were collected in two groups. Group I were treated by crossectomy and foam sclerotherapy of the GSV and group II were treated by stripping of GSV and varicectomy. The healing time of the ulcer and the complications were recorded after the procedure in the follow-up visits. Results. 29 out of the 35 patients completed the follow-up. There were eight cases of incomplete healing of the leg ulcer, 4 in group I (19.04%) and 4 in group II (40%), P<0.05. The average rate of healing in group I was 0.38 cm/day and 0.13 in group II, P<0.05. Conclusion. CAFE technique of the great saphenous vein in the treatment of 6 CEAP patients is a procedure that improves the rate of ulcer healing as compared to these two groups. It is a safe and reliable minimally invasive method, with less morbidity.

scholarly journals COMPARATIVE EVALUATION OF THE RESULTS OF SURGICAL TREATMENT OF ACUTE ASCENDING THROMBOPHLEBITIS OF THE GREAT SAPHENOUS VEIN USING THE ENDOVASCULAR HIGH-FREQUENCY WELDING TECHNIQUE AND TRADITIONAL TECHNIQUE

2020 ◽  
Vol 73 (4) ◽  
pp. 638-641
Author(s):  
Serhiy I. Savolyuk ◽  
Valentyn A. Khodos ◽  
Roman A. Herashchenko ◽  
Vladyslav S. Horbovets
Keyword(s):  
Saphenous Vein ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Great Saphenous Vein ◽  
Pain Syndrome ◽  
Surgical Operation ◽  
Electric Welding ◽  
Group I ◽  
Group Ii ◽  
Welding Technique

The aim of the study was to conduct a comparative evaluation of the effectiveness of surgical treatment of acute ascending thrombophlebitis of the great saphenous vein using the endovascular high-frequency welding technique and traditional phlebectomy. Materials and methods: Two groups were formed in the conducted study. Group I included patients (n=42) with the acute ascending thrombophlebitis of the great saphenous vein, in whom their thrombosed great saphenous vein was removed using the endovascular high-frequency welding technique. As a source of current, an EK300M1 Svarmed electric welding machine (Ukraine) was used. Electric welding of a thrombosed vein segment was carried out using the endovenous electric welding catheter. Group II included patients (n=31) with the acute ascending thrombophlebitis of the great saphenous vein, who underwent the traditional phlebectomy of the thrombosed great saphenous vein according to Babcock’s technique. Results: In group I no patient revealed presence of pain syndrome with significant intensity during the postoperative period. An infiltrate along the coagulated segments of the great saphenous vein, postoperative oedema and paresthesiae were observed in considerably fewer cases from group I versus group II (р=0.0005, р=0.0001, р=0.0018). During their follow-up for more than 12 months, 2 (4.76 %) of 42 patients from group I revealed partial recanalization of the great saphenous vein (р=0.632). In group I the postoperative inpatient period was 1.3±0.1 days. In group II the above period averaged 4.8±0.8 days (p<0.001). Absence of an intense pain syndrome in group I was caused by a gentle effect of high-frequency electric current itself on the venous wall and paravasal structures. A significant reduction of side effects and complications with a shorter stay of patients in hospital versus the traditional phlebectomy was achieved owing to reduction in the extent of injury of the surgical operation itself with the use of endovascular high-frequency welding. Conclusions: The technique of endovascular high-frequency welding in treatment of acute ascending thrombophlebitis of the great saphenous vein makes it possible to reduce the extent of injury of the surgical operation versus the traditional phlebectomy, results in a significant decrease in the number of side effects and complications and shortens the period of the patient’s stay in hospital.

Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein?

2018 ◽  
Vol 33 (9) ◽  
pp. 646-652 ◽  
Author(s):  
Orsini Camillo
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Statistical Significance ◽  
Long Term Results ◽  
Complication Rates ◽  
Foam Sclerotherapy ◽  
Occlusion Rate ◽  
Long Term Experience

Objective This retrospective study presents the long-term results of catheter-directed foam sclerotherapy of the great saphenous vein. Method From January 2003 to June 2017, 277 patients with varices and great saphenous vein incompetence were treated with echo-guided foam sclerotherapy. Forty-six patients were treated with long-catheters guided by foam sclerotherapy. Foaming was carried out with sodium-tetra-decyl-sulphate. Results Results were examined in the two groups: A (long-catheters) and B (other procedures). The median overall follow-up was 52.1 months. In the A-group, the complete occlusion rate was 34/46 pts (73.9%) and partial occlusion was 10/46 (21.7%). In the B-group, respectively, 130/231 (56.2%) and 90/231 (38.9%). Comparisons between groups were statistically significant (p = 0.023; p = 0.021). Failures involved, respectively, 2/46 (4.3%) and 11/231 (4.7%) with no statistical significance. The complication rates were similar in the two groups. Conclusions In this long-term experience (median follow-up exceeding four years), foam-guided sclerotherapy of the great saphenous vein with a long-catheter turned out to be more effective than the usual foam-guided sclerotherapy.

scholarly journals ClariVein® – Early results from a large single-centre series of mechanochemical endovenous ablation for varicose veins

2016 ◽  
Vol 32 (1) ◽  
pp. 6-12 ◽  
Author(s):  
TY Tang ◽  
JW Kam ◽  
ME Gaunt
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Single Centre ◽  
Foam Sclerotherapy ◽  
Early Results ◽  
Endovenous Ablation ◽  
The Uk

Objectives This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. Methods A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment. Postoperative complications were recorded along with patient satisfaction. Results All 393 procedures were completed successfully under local anaesthetic. Complete occlusion of the treated vein was initially achieved in all the patients, but at eight weeks’ follow-up, there was only partial obliteration in 13/393 (3.3%) veins. These were all successfully treated with ultrasound-guided foam sclerotherapy. Procedures were well tolerated with a mean pain score of 0.8 (0–10). No significant complications were reported. Conclusions ClariVein® can be used to ablate long and short saphenous varicose veins on a walk-in–walk-out basis. Bilateral procedures can be successfully performed, and these are well tolerated as can multiple veins in the same leg. Early results are promising but further evaluation and longer term follow-up are required.

scholarly journals Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis

2013 ◽  
Vol 30 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Wayne S Gradman
Keyword(s):  
Saphenous Vein ◽  
Initial Treatment ◽  
Definitive Treatment ◽  
Superficial Vein ◽  
Vein Thrombosis ◽  
Group I ◽  
Superficial Vein Thrombosis ◽  
Group Ii ◽  
Deep Vein

Objective: The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation. Methods: In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs ( n = 41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs ( n = 31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh. Results: In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation. Conclusions: The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux.

Triple-lumen double-balloon catheter for foam sclerotherapy of the great saphenous vein: critical review on preliminary results

2010 ◽  
Vol 25 (5) ◽  
pp. 241-245 ◽  
Author(s):  
S Reich-Schupke ◽  
P Altmeyer ◽  
M Stücker
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Balloon Catheter ◽  
Case Series ◽  
Foam Sclerotherapy ◽  
Direct Puncture ◽  
Double Balloon ◽  
Single Balloon ◽  
Angiography Catheter

Background Different catheters (angiography, single-balloon) have been used for foam sclerotherapy of the great saphenous vein (GSV). Objective Is there greater efficacy and safety in the use of a double-balloon catheter? Methods Twenty patients were treated with a double-balloon catheter and 3% polidocanol foam. Follow-up after one day, one and six weeks, six and 12 months. Results Up to week six complete success was seen in 95% (19/20) patients. Only eight patients attended the checks after six and 12 months. The occlusion rates were 75% (6/8, 6 months) resp. 50% (4/8, 12 months). A further 10 patients refused these checks as they were free of symptoms but could be questioned. Side-effects were haematoma (100%), limited phlebitis (15%) and one extended thrombophlebitis followed by hyperpigmentation. Conclusion A double-balloon catheter is a safe treatment option for foam sclerotherapy of the GSV. However, in this case series efficacy is not superior to the use of an angiography-catheter, a single-balloon catheter or just the direct puncture of the vein.

Partial Versus Total Stripping of the Great Saphenous Vein Evaluated by Strain-Gauge Plethysmography

1991 ◽  
Vol 6 (4) ◽  
pp. 227-232 ◽  
Author(s):  
Morten Helsted ◽  
Jørgen Hesselfeldt-Nielsen ◽  
Frits R. Mathiesen
Keyword(s):  
Saphenous Vein ◽  
Strain Gauge ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Previous Treatment ◽  
Saphenous Nerve ◽  
Strain Gauge Plethysmography ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

This study was undertaken in order to assess the necessity of stripping the great saphenous vein totally or partially in the treatment of varicose veins. Thirty-four patients with varicose veins with no previous treatment were allocated to one of the two following treatments: sapheno–femoral ligation and complete stripping from the groin to the ankle with ligature of incompetent perforators and avulsion of visible varicose veins (group I); and partial stripping from the groin to 5 cm below the line of the knee joint and otherwise treated as mentioned above (group II). All patients were examined clinically before and 3 months after surgery to assess their varicose veins and the sensitivity in the saphenous nerve area. They were all investigated by strain-gauge plethysmography, recording venous return-time (RT) and expelled volume (EV). The patients scored their subjective findings on visual analogue scales (VAS) assessing discomfort, swelling and visual appearance. The Plethysmographic results of the two groups showed that RT increased by 25.5 and 22.5 s, respectively, to 53.4 and 63.6 s (median values) (normal RT > 42 s). The increment of the two groups, is significant, but a comparison does not show any significant difference. The EV-values showed nonsignificant changes. Saphenous nerve damage was found in five of 15 patients in group I and in one of 19 in group II, but this difference is not statistically significant ( P < 0.10). The VAS scores showed a significant improvement in both groups, in terms of discomfort and visible appearance, but that they did not differ in these respects. We conclude that partial stripping does not lead to a different outcome from total stripping, and that partial stripping seems to be the preferable treatment of primary varicose veins.

scholarly journals Cost-Effective Management of Venous Ulcer

1970 ◽  
Vol 2 (2) ◽  
pp. 136-141
Author(s):  
SAN Alam ◽  
AHM Bashar ◽  
KM Alam ◽  
MN Sabah ◽  
GMM Hossain ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Ulcer Healing ◽  
Great Saphenous Vein ◽  
Cost Effective ◽  
Venous Ulcer ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Group I ◽  
Venous Surgery ◽  
Group Ii

Background: Venous disorders are very common. About 20% of the population suffer from varicose veins, 2% have skin changes which may precede venous ulceration. Venous ulcers represent a common and debilitating condition associated with significant financial loss for the patients as well as the society. Treatment options for these patients are costly and time consuming. In this study we tried to find out cost-effective measures for treating this group of patients.Method: To evaluate the effectiveness and safety of superficial and perforating leg venous surgery along with pharmacotherapy 66 patients with chronic venous leg ulcers are prospectively studied. After proper history taking and clinical examination all patients underwent venous duplex ultrasonography. Patients were divided into two groups. Group I (n=30) includes patients undergoing saphenofemoral ligation and stripping of the great saphenous vein (GSV). In group II (n=36) patients underwent saphenofemoral and incompetent leg perforator ligation along with stripping of the GSV. Conservative measures, local ulcer care and pharmacotherapy were common in both groups.Result: Postoperative complications, total hospital stay and ulcer healing were studied. Ulcer healing was earlier in group II. Remarkable complications were similar in both the groups.Conclusion: For effective and economic care of venous leg ulcers, combination of standard surgical procedures including incompetent perforator and saphenofemoral ligation with great saphenous vein stripping and standard physio-pharmacotherapeutic care is essential. This combined modality of treatment is highly effective in early and complete ulcer healing in patients suffering from venous ulcers.Keywords: Venous ulcer: Saphenofemoral ligation: Perforator ligation.  DOI: 10.3329/cardio.v2i2.6629Cardiovasc. j. 2010; 2(2) : 136-141

Catheter-directed foam sclerotherapy with tumescence of the great saphenous vein versus ultrasound-guided foam sclerotherapy: A randomized controlled trial

2019 ◽  
Vol 35 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Jorgete B dos Santos ◽  
Walter Campos Júnior ◽  
Rina MP Porta ◽  
Juliana Puggina ◽  
Daniela FT da Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Success Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Number Of Patients

Objectives To compare the effectiveness of two foam sclerotherapy techniques of the great saphenous vein. Methods Fifty subjects with varicose veins, edema, and great saphenous vein incompetence (diameter 6–10 mm) were randomly categorized into two equal groups and were treated with different foam sclerotherapy techniques: A (usual ultrasound-guided) and B (catheter-directed with tumescence). Concomitant phlebectomy was performed in all patients. Patients were seen on days 7 and 28, and at six and 12 months. The primary outcomes were the full success rate of the treated great saphenous vein and the number of patients who required retreatment sessions performed at 28-day follow-up. The secondary-assisted outcomes were the full success rates of the treated great saphenous vein after the retreatment sessions at six- and 12-month follow-up. Secondary outcomes were changes in quality of life and side effects and complications of the intervention. In case of reflux, retreatment sessions were performed at 28 days and six months in both groups. Results Full success rate of the treated great saphenous vein was 36% in group A vs. 80% in group B ( p = 0.012) and the number of patients who required retreatment sessions were n = 14 in group A vs. n = 3 in group B at 28-day follow-up ( p = 0.002). Both were statistically significant. At six and 12 months, the success rates were not statistically significant between the groups. Complication rates were similar between the groups. Quality of life improved in both groups with statistical difference ( p < 0.001). Conclusions Catheter-directed foam sclerotherapy with tumescence was better than usual ultrasound-guided foam sclerotherapy as it reached higher full success rate of the treated great saphenous vein and as a lower number of patients required retreatment sessions in the short-term. Both methods proved to be safe and improved the quality of life.

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