Document Detail


The effect of long saphenous vein stripping on deep venous reflux.
MedLine Citation:
PMID:  15177239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The addition of long saphenous vein (LSV) stripping to sapheno-femoral junction (SFJ) disconnection and multiple stab avulsions (MSAs) in the course of varicose vein (VV) surgery is associated with a significant reduction in recurrence, and a significant improvement in quality of life. It is hypothesised that these benefits relate, at least in part, to a favourable effect of stripping on deep venous reflux. OBJECTIVE: To examine the effect of long saphenous vein (LSV) stripping on deep venous reflux (DVR). METHODS: This was prospective study of 62 consecutive patients (77 limbs) CEAP class 2-6, undergoing SFJ disconnection and MSAs, with and without successful stripping of the LSV to the knee. A duplex ultrasound examination was performed pre-operatively and at a median (IQR) of 24 (23-25) months post-operatively. Completely stripped limbs were defined as those in whom complete stripping of the LSV to the knee was confirmed on post-operative duplex. Reflux >/=0.5 s. was considered pathological. RESULTS: Pre-operatively, 32 (42%) limbs had deep venous reflux (DVR). Post-operative duplex at 24 months revealed that the LSV had been completely stripped in 29 (38%) limbs. In patients with pre-operative DVR, complete stripping was associated with a significant reduction in the prevalence of superficial femoral vein (SFV) (p<0.001) and popliteal vein (PV) (p=0.016), McNemar test) on post-operative duplex. By contrast, in patients without pre-operative DVR, incomplete stripping was associated the development of SFV (p=0.031) and PV (p=0.008) reflux. CONCLUSIONS: Complete LSV stripping abolishes DVR in a significant proportion of limbs, whereas failure to strip is frequently associated with the development of new DVR. These data support for routine stripping and suggest that the benefits of stripping may relate, at least in part, to a favourable impact on deep venous function.
Authors:
R K MacKenzie; P L Allan; C V Ruckley; A W Bradbury
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Publication Detail:
Type:  Comparative Study; 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 Jul 
Date Detail:
Created Date:  2004-06-04     Completed Date:  2004-09-30     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:  104-7     Citation Subset:  IM    
Affiliation:
Vascular Surgery Unit, Royal Infirmary, Edinburgh, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Extremities / blood supply*,  surgery,  ultrasonography
Female
Femoral Vein / pathology,  surgery,  ultrasonography
Humans
Male
Middle Aged
Popliteal Vein / pathology,  surgery,  ultrasonography
Postoperative Complications / epidemiology,  etiology,  ultrasonography
Prevalence
Prospective Studies
Recurrence
Saphenous Vein / pathology,  surgery,  ultrasonography
Statistics as Topic
Treatment Outcome
Ultrasonography, Doppler, Duplex
Varicose Veins / surgery*,  ultrasonography
Vascular Surgical Procedures*
Venous Insufficiency* / surgery,  ultrasonography
Comments/Corrections
Comment In:
Eur J Vasc Endovasc Surg. 2004 Nov;28(5):567-8   [PMID:  15465383 ]
Eur J Vasc Endovasc Surg. 2004 Oct;28(4):453-4   [PMID:  15350575 ]

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


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