Document Detail

Improvement in deep vein haemodynamics following surgery for varicose veins.
MedLine Citation:
PMID:  15465367     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: o analyse the effect of superficial and perforating veins surgery on deep vein incompetence. METHODS: During a six-month period between 2000 and 2001 24 patients (32 limbs) with chronic venous insufficiency (CVI) were treated. They were selected because they had varicose veins and proximal deep vein incompetence with photoplethysmography (PPG) venous refilling time (VRT) <15 s with a below knee tourniquet, and a femoral or popliteal vein reflux time (RT) >1.5 s on duplex ultrasound. The group was divided according to aetiology into 21 legs with primary (Ep) and 11 with secondary CVI (Es). All patients underwent removal of varices with stripping of the saphenous veins, if appropriate. In 21 cases subfascial endoscopic perforating vein surgery (SEPS) was performed to ligate incompetent perforating veins. RESULTS: The average VRT for the entire group increased from 9.8 s before to 15 s after operation (p<0.001, paired t test). In the Ep group the average VRT increased from 11 to 18 s (p<0.001, paired t test), in Es group from 7.5 to 10 s (p>0.001, paired t test). Duplex ultrasonography before surgery showed femoral vein incompetence in 28 and the popliteal incompetence in 26 cases. The average femoral vein RT was 1.9 s before and 1.4 s after surgery (p<0.001, paired t test). The femoral RT in the Ep group decreased from 1.9 to 1.3 s (p<0.001, paired t test) and in the Es group from 1.9 to 1.6 s (N.S.). In the popliteal vein, RT was 1.8 s before, and 1.3 s after surgery (p<0.001, paired t test). The RT in the Ep group shortened from 1.8 to 1.1 s (p<0.001 paired t test) and in the Es group from 1.9 to 1.5 s (N.S.). CONCLUSION: Surgical treatment of varicose veins and of calf perforators results in reduced deep vein reflux. The improvement is most marked in cases of primary venous insufficiency.
P Ciostek; J Michalak; W Noszczyk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  28     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2005-03-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  473-8     Citation Subset:  IM    
Second Medical Division, First Department and Chair of General and Vascular Surgery, Warsaw Medical Academy, Warsaw, Poland.
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MeSH Terms
Middle Aged
Treatment Outcome
Ultrasonography, Doppler, Duplex
Varicose Veins / complications,  physiopathology,  surgery*
Vascular Surgical Procedures / methods*
Venous Insufficiency / complications,  diagnosis,  physiopathology,  surgery*

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