Document Detail


Division of incompetent perforator veins and subfascial interposition of a polypropylene foil in post-thrombotic syndrome. Preliminary results.
MedLine Citation:
PMID:  15041937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The safety, feasibility and early efficacy of subfascial endoscopic perforator surgery was gradually accepted for patients who had severe chronic venous insufficiency but, in the literature, the recurrence rate of ulceration is about 10-40%, especially in patients with previous deep vein thrombosis (DVT). METHODS: From October 1998 to February 2002, 205 patients with 280 inferior leg ulcers were followed; 115 had venous ulcers but only 20 patients had chronic ulcers with previous DVT; 4 patients were excluded and only 16 patients (9 female, 7 male, mean age 61 years) with 18 chronic ulcers were included. These patients underwent sub-aponeurotic interruption of perforating veins with blind technique in association with subfascial interposition of a hand-made polypropylene foil. Eight of these patients had persistent non-healing ulcers at the time of surgery and 10 had chronic recurrent ulceration healed at the time of the surgical procedure. All patients were assessed clinically and with duplex scanning. RESULTS: The follow-up was done clinically and with eco-Doppler from 6 to 38 months with a mean follow up period of 23.2 months. The healing rate was 100%. The 2-year life table incidence of ulcer recurrence was 0%. Hospital stay ranged from 1-2 days, early operative complications included extensive ecchymosis in 1 patient, oedema in 3 patients. CONCLUSION: The division of perforating veins, with the subfascial support of a polypropylene foil give promising results in the treatment of venous ulcers in post-thrombotic syndrome with low morbidity and short hospital stay.
Authors:
G Vettorello
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  45     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-25     Completed Date:  2004-05-20     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  49-53     Citation Subset:  IM    
Affiliation:
Department of General Surgery, General Hospital, Tolmezzo, Udine, Italy. gfvettorello@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Angioscopy / adverse effects,  methods*
Blood Vessel Prosthesis Implantation / adverse effects,  methods*
Chronic Disease
Dissection / adverse effects,  instrumentation,  methods
Ecchymosis / etiology
Echocardiography, Doppler
Edema / etiology
Fascia
Feasibility Studies
Female
Follow-Up Studies
Humans
Incidence
Length of Stay / statistics & numerical data
Life Tables
Ligation / adverse effects,  instrumentation,  methods*
Male
Middle Aged
Morbidity
Polypropylenes
Postphlebitic Syndrome / classification,  surgery*,  ultrasonography
Recurrence
Treatment Outcome
Varicose Ulcer / classification,  surgery*,  ultrasonography
Wound Healing
Chemical
Reg. No./Substance:
0/Polypropylenes

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


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