Document Detail


Defining the role of extended saphenofemoral junction ligation: a prospective comparative study.
MedLine Citation:
PMID:  11054226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study explores the added effect of extended saphenofemoral junction (SFJ) ligation when the greater saphenous vein (GSV) has been eliminated from participating in thigh reflux by means of endovenous obliteration. GSV obliteration, unlike surgical stripping, can be done with or without SFJ ligation to isolate and study SFJ ligation's specific contribution to treatment results.
METHODS: Sixty limbs treated with SFJ ligation and 120 limbs treated without high ligation were selected from an ongoing, multicenter, endovenous obliteration trial on the basis of their having primary varicose veins, GSV reflux, and early treatment dates.
RESULTS: Five (8%) high-ligation limbs and seven (6%) limbs without high ligation with patent veins at 6 weeks or less were excluded as unsuccessful obliterations. Treatment significantly reduced symptoms and CEAP clinical class in both groups (P =.0001). Recurrent reflux developed in one (2%) of 49 high-ligation limbs and eight (8%) of 97 limbs without high ligation by 6 months (P =.273). New instances of reflux did not appear thereafter in 57 limbs followed to 12 months. Recurrent varicose veins occurred in three high-ligation limbs and four limbs without high ligation by 6 months and in one additional high-ligation limb and two additional limbs without high ligation by 12 months. Actuarial recurrence curves were not statistically different with or without SFJ ligation (P >.156), predicting greater than 90% freedom from recurrent reflux and varicosities at 1 year for both groups.
CONCLUSION: These early results suggest that extended SFJ ligation may add little to effective GSV obliteration, but our findings are not sufficiently robust to warrant abandonment of SFJ ligation as currently practiced in the management of primary varicose veins associated with GSV vein reflux.
Authors:
J G Chandler; O Pichot; C Sessa; S Schuller-Petrović; F J Osse; J J Bergan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  32     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-14     Completed Date:  2000-12-14     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  941-53     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Colorado Health Sciences Center and VNUS Medical Technologies, Boulder, CO, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Balloon Occlusion / methods*
Female
Femoral Vein*
Follow-Up Studies
Humans
Ligation / methods
Male
Middle Aged
Prospective Studies
Reference Values
Saphenous Vein*
Severity of Illness Index
Statistics, Nonparametric
Treatment Outcome
Ultrasonography, Doppler, Duplex
Varicose Veins / surgery,  therapy*,  ultrasonography
Vascular Patency
Comments/Corrections
Comment In:
Curr Surg. 2003 May-Jun;60(3):254-9   [PMID:  15212062 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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