5-year experience with varicose vein laser surgery

2012 ◽  
Vol 153 (47) ◽  
pp. 1863-1869
Author(s):  
Imre Bihari ◽  
George Ayoub ◽  
András Bihari
Keyword(s):  
Recurrence Rate ◽  
Varicose Vein ◽  
Lower Limb ◽  
Laser Surgery ◽  
Laser Energy ◽  
Varicose Veins ◽  
Lower Limbs ◽  
High Recurrence Rate ◽  
Complication Rates ◽  
Saphenous Veins

Introduction: The incidence of varicose veins in the lower limb is relatively frequent in Europe including Hungary. Aim: Authors report their 5-year experience in varicose vein laser surgery focusing with regards to recurrence and complication rates. Patients and methods: Surgery was performed on 647 lower limbs in 546 patients with an age between 17 and 80 years. They were overweight in 4.6 % of cases. The diameter of treated saphenous veins was between 4 and 31 mm. Indications for surgery were recurrence in 9.1% of cases and crural ulcer in 4.0% of cases. Laser fibre was introduced into the varicose saphenous stems and then 980 nm, later 1470 nm wavelength laser was delivered while the fibre was step-by-step pulled-out. Following the learning period laser energy was raised from a mean of 28 J/cm to 164 J/cm because of high recurrence rate. Results: During the learning period the recurrence rate was 13.8% while it was 1.9% thereafter. Pulmonary embolism occurred in two cases, which could have been avoidable. Further minor complications were also noted. Conclusions: Varicose vein laser surgery can be recommended because the recurrence rate is very low, major complications can be avoided and minor complications are temporary. Orv. Hetil., 2012, 153, 1863–1869.

scholarly journals Lower Limb Varicose Veins's Clinical Profile and Management

2020 ◽  
pp. 1-5
Author(s):  
C. Z. Perdeshi ◽  
Kustub A. Kulkani ◽  
Revendra N. Yadav ◽  
Mayur Nagwakar ◽  
Niten H. Patil
Keyword(s):  
Varicose Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
Lower Limbs ◽  
Study Results ◽  
Common Technique ◽  
Age Range ◽  
Made In

The lower limbs’ venous system has the pressure of posture, and blood has to be pushed against gravity into the heart cavity. This issue is generally approached either by a cautious approach or by surgical interference, all of which are constrained. Attempts to study different clinical manifestations of varicose veins are being made in the present study. The overall number of 50 varicose vein patients was analysed and the study results were reported. Varicosity veins of the lower limb is a fairly normal pathological entity. In the 20-50 age range, the condition is more common. The main modality of the procedure is surgery. The most common technique performed is Saphenofemoral flush ligation with stripping. 

scholarly journals Variants of Localization and Extension of Hypo- and Aplasia of the Great Saphenous Vein in Patients with Primary Varicose Great Saphenous Veins

2019 ◽  
Vol 25 (2) ◽  
Author(s):  
Rostyslav Sabadosh
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Ultrasound Scan ◽  
Saphenous Veins ◽  
Vein Segment ◽  
Surgical Tactics ◽  
The Relationship

The objective of the research was to improve the diagnostics and treatment of patients with primary varicose great saphenous veins by studying their frequency and systematizing the variants of localization and extension of great saphenous vein hypoplasia and aplasia in its trunk. Materials and Methods. The study included 560 patients with varicose veins of the lower limbs and pathological refluxes in different segments of the great saphenous vein. All the patients underwent triplex ultrasound scan of the lower limb venous system. Results. Among the patients with pathological reflux in a certain GSV segment, hypo- and aplasia of its segments were observed in 32.5% of the cases (95% CI 28.6-36.6%). Aplasia of this vein was observed twice as less frequently than hypoplasia (p<0.05). In 2.3% of the cases (95% CI 1.2-3.9%), hypoplasia of a certain GSV segment evolved to aplasia, or vice versa. It was found that the GSV trunk may have several hypo- or aplastic regions separated by its normal or varicose segment – bi-level hypo- or aplasia that was observed in 3.8% of the patients with hypo- or aplasia (95% CI 1.6-7.8%). In bi-level hypo- or aplasia, 2 hypoplastic regions were detected in 85.7% of the cases (95% CI 42.1-99.6%) and 2 aplastic regions were found in 14.3% of the cases (95% CI 0.4-57.9%). There were proposed to distinguish the following variants of GSV hypo- and aplasia: 1) simple: total, proximal, segmental and distal; 2) bi-level: proximal segmental, distal segmental and bi-segmental. In addition, for every dysplastic vein segment, the type of malformation should be indicated, namely hypoplasia, aplasia, or hypo/aplasia. Conclusions. The study conducted allowed assessing the relationship between the variants of GSV hypo- and aplastic segment localization and extension and different variations of pathological refluxes of the GSV in its trunk for further choice of surgical tactics.

scholarly journals Tratamento cirúrgico de varizes de membros inferiores em paciente hemofílico: relato de caso / Surgical treatment of lower limb varicose veins in a hemophiliac patient: case report

2019 ◽  
Vol 64 (3) ◽  
pp. 258
Author(s):  
Camila Teixeira Campos ◽  
Romulo Teixeira de Oliveira ◽  
Wanderley De Paula ◽  
Ygor Minassa Alves
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Vascular Surgery ◽  
Factor Viii ◽  
Varicose Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Vein Resection ◽  
Hemophiliac Patient

Objetivo: Relatar uma situação rara na especialidade cirúrgica vascular, aparentemente ainda sem documentação de experiência semelhante e que consiste no tratamento cirúrgico de varizes de membros inferiores em paciente hemofílico e com sintomatologia venosa. Relato de caso: Procedimento cirúrgico realizado no Hospital Evangélico de Vila Velha, no setor de Cirurgia Vascular no ano de 2018, em paciente hemofílico e portador de veias varicosas primárias sintomáticas em membros inferiores. Realizado intervenção cirúrgica convencional com safenectomia bilateral e ressecção de varizes tronculares com infusão endovenosa de fator VIII no pré-operatório e nos 10 dias subsequentes. Necessitou de acompanhamento multidisciplinar incluindo hematologista e apresentou evolução satisfatória, sem intercorrências hemorrágicas. O paciente retornou no 14º de pós-operatório sem complicações. Concluímos que é perfeitamente possível a realização de cirurgia venosa de varizes com técnica convencional em paciente portador de doença hemofílica, bastando para isso a recomendada infusão de fator VIII.Descritores: Hemofilia A, Varizes, Procedimentos cirúrgicos vascularesAbstractObjective: To report a rare situation in the vascular surgical specialty, apparently still without documentation of similar experience, which consists in the surgical treatment of lower limb varicose veins in a hemophiliac patient with venous symptomatology. Case report: Surgical procedure performed at the Evangelical Hospital of Vila Velha, in the Vascular Surgery sector in 2018, in a hemophilic patient with symptomatic primary varicose veins in the lower limbs. Conventional surgical intervention was performed with bilateral saphenous vein resection and trunk varicose vein resection with intravenous factor VIII infusion preoperatively and in the 10 subsequent days. It was required multidisciplinary follow-up including hematologist and presented satisfactory evolution, without hemorrhagic complications. The patient returned in the 14th postoperative period without complications. It was concluded that to perform varicose vein surgery with conventional technique in a patient with hemophilic disease is perfectly possible with the recommended factor VIII infusion.Keywords: Hemophilia A, Varicose veins, Vascular surgery procedures 

Lower Limb Deep Venous Incompetence is Rare in Patients Undergoing Obesity Surgery

2000 ◽  
Vol 15 (1) ◽  
pp. 30-32 ◽  
Author(s):  
A. Westling ◽  
A. Boström ◽  
S. Gustavsson ◽  
S. Karacagil ◽  
D. Bergqvist
Keyword(s):  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Saphenous Veins ◽  
The Common

Objective: To investigate the incidence of lower limb venous insufficiency in morbidly obese patients. Patients and methods: The study group comprised 125 patients (109 women, 16 men). The median (range) age and body mass index were 35 (19–59) years and 42 (32–68) kg/m2 respectively. Eleven patients had clinical signs of varicose veins or had previously undergone varicose vein surgery. Patients were investigated with duplex ultrasound scanning on the day before surgery. Iliac, femoral, popliteal, and long and short saphenous veins in both legs were studied. Results: A total of 33 patients had abnormal reflux in the superficial veins (>0.5 s). In the deep veins 2 patients had valvular incompetence in the common femoral vein with reflux times of 2 and 0.7 s respectively. At reinvestigation 18 and 24 months after surgery the reflux times were normalised. Conclusion: In this study the incidence of deep venous incompetence in the lower limb in morbidly obese patients is low.

Causes of recurrent lower limb varicose veins after surgical interventions in 141 limbs – Five-year retrospective analysis of two centers

Vascular ◽  
2013 ◽  
Vol 22 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Wang Rui Hua ◽  
Meng Qing Yi ◽  
Wu Xue Jun ◽  
Jin Xing ◽  
Liu Zhao Xuan ◽  
...  
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Lower Limbs ◽  
Venous Reflux ◽  
Surgical Interventions ◽  
Venous Valves ◽  
Second Surgery ◽  
Clinical Changes

Aim The purpose of this study was to explore the causes of recurrent lower limb varicose veins after surgical interventions. Methods A retrospective five-year survey was conducted on patients who underwent second surgery due to recurrent lower limb varicose veins after surgical interventions. A total of 141 limbs (112 cases), including 72 cases of left lower limbs, 47 of right lower limbs and 22 of both limbs, were involved in the study. All patients underwent lower limb venography (141 limbs were anterograde and 28 cases were retrograde), and then examined with color-Doppler ultrasound. Results The major causes that urged patients to undergo second surgery are clinical changes graded above CEAP IV (93.6%), limb edema without changes on skin (5%), and single varicosity (1.4%). Up to 127 (83%) limbs exhibited perforating venous reflux, 67 (47.5%) limbs had varied degrees of deep venous insufficiency and 68 (48.2%) limbs had through or above-the-knee great saphenous vein trunk residual. Conclusions Preoperative venography before operation is indispensible in confirming the diagnosis and operation strategies. Patients with severe primary deep venous reflux and symptoms up to C3 may need simultaneous repair of the deep venous valves.

scholarly journals Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Orlando Adas Saliba Júnior ◽  
Mariangela Giannini ◽  
Ana Paula Mórbio ◽  
Orlando Saliba ◽  
Hamilton Almeida Rollo
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Varicose Vein Surgery ◽  
Postoperative Evaluation ◽  
Perforating Veins ◽  
Primary Varicose Veins ◽  
Ceap Classification ◽  
The Mean ◽  
Deep Vein

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM).Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM.Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P<0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins.Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

scholarly journals The role of transillumination phleboscopy in the planning of cosmetic operations for varicose veins

2009 ◽  
Vol 8 (4) ◽  
pp. 313-317
Author(s):  
Ricardo C. Rocha Moreira ◽  
Márcio Miyamotto ◽  
Ramzi Abdallah El-Hosni Jr. ◽  
Barbara D’Agnoluzzo Moreira
Keyword(s):  
Varicose Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Careful Planning ◽  
Operations Planning ◽  
Cosmetic Results ◽  
Essential Step ◽  
Main Activity ◽  
Reticular Veins

Background: The cosmetic treatment of varicose veins is the main activity of most vascular surgeons in Brazil. In order to obtain satisfactory cosmetic results, careful planning of varicose vein operations is necessary. Objective: Marking (or "mapping") the varicose veins with indelible ink is an essential step in planning cosmetic surgeries for lower limb varicose veins. In the present study, the role of transcutaneous phleboscopy (TcPh) in planning varicose vein operations is evaluated. Methods: A series of 100 consecutive patients, all female, were evaluated with TcPH as part of their varicose vein operations planning. A total of 171 limbs with varicose veins (71 bilateral and 29 unilateral) were evaluated. The process of marking the varicose veins followed the same protocol in all cases. Firstly, the varicose veins were marked by inspection and palpation, with the patient standing, using an indelible black ink pen. Secondly, with the patients resting in supine and prone positions, the varicose veins detected with TcPh were marked again with red or blue ink. The marks made by the two methods were then compared. Results: In 41 patients, for a total of 80 limbs (46.8%), the marks were altered after use of TcPh. Reasons for such changes were: 1) identification of other varicose veins; 2) identification of reticular veins draining complex telangiectasias; and 3) changes in the position of the marks placed with the patient standing. Conclusions: TcPh has altered the planning of varicose vein surgeries in 46.8% of all limbs evaluated, especially when the patients had complex telangiectasias, associated with reticular varicose veins.

scholarly journals DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS

2020 ◽  
Vol 71 (2) ◽  
pp. 457-470
Author(s):  
Mohammed Hatem ◽  
Mahmoud Sobhy ◽  
Wageh Fawzy ◽  
Karem Sabry ◽  
Ahmed Al-Taher
Keyword(s):  
Laser Ablation ◽  
Recurrence Rate ◽  
Lower Limb ◽  
Varicose Veins ◽  
Endovenous Laser Ablation

scholarly journals Ways of Improvement of Safety and Efficiency of Endovenous Laser Coagulation in Treatment of Lower Limb Varicose Vein Disease

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Roman Kohan ◽  
Volodymyr Goshchynsky
Keyword(s):  
Mathematical Model ◽  
Laser Radiation ◽  
Varicose Vein ◽  
Lower Limb ◽  
Linear Density ◽  
Varicose Veins ◽  
Laser Coagulation ◽  
Light Pipe ◽  
The Mathematical Model ◽  
Vein Disease

Nowadays endovenous laser coagulation is the priority method of treatment of lower limb varicose vein disease. However, there are a number of specific complications that reduce efficiency of its usage.The objective of the research was to decrease specific postoperative complications after endovenous laser coagulation due to the introduction of its mathematical design.Materials and methods. The study included 168 patients with lower limb varicose vein disease. Prior to surgery the mathematical calculation of the basic parameters of laser coagulation such as density of laser irradiation and rate of reverse movement of the light pipe depending on the diameter of varicose veins was made. The control group consisted of 146 patients with varicose vein disease; the aforementioned parameters were established according to the instruction of using a laser device.Results.  The analysis of complications such as induration of skin over coagulase great or small saphenous vein, phlebitis in the projection of the great or small saphenous vein, ecchymosis or dermatomelasma in the early postoperative period, pain syndrome showed the reduction in the number of complications while applying the mathematical model of calculation of linear density of laser radiation and the speed of reverse traction of the light pipe with its transfer to the graphic image.Conclusions.  The application of the mathematical model of calculation of linear density of laser radiation and the speed of reverse traction of the light pipe with its transfer to the graphic image allows us to improve the results of endovenous laser coagulation for varicose veins due to the reduction in specific complications.

scholarly journals Vein Glue VenaSeal® for the Therapy in Case of Varicose Vein Thrombosis: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Zierau UT
Keyword(s):  
Deep Vein Thrombosis ◽  
Case Report ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Rare Complication ◽  
Vein Thrombosis ◽  
Saphenous Veins ◽  
Deep Vein

The thrombosis in areas of the superficial truncal varicose veins and cutaneous veins is not a rare complication; it requires drug or surgical therapy if the thrombosis grows in the direction of deep veins. This situation is particularly striking in the case of thromboses of the great saphenous vein GSV and small saphenous vein SSV as well as other saphenous veins and leads to deep vein thrombosis in around 20% of cases. We will report about a case of SSV thrombosis and the catheter-based therapy of thrombosis following the therapy of truncal varicose vein SSV with VenaSeal® in one session.

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