Role of superficial venous surgery in patients with combined superficial and segmental deep venous reflux
Objectives: superficial venous surgery heals chronic venous ulceration (CVU) in the majority of patients with isolated superficial venous reflux (SVR). This study examines the role of superficial venous surgery in patients with comined SVR and segmental deep venous reflux (DVR). Methods: combined SV...
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| Veröffentlicht in: | European journal of vascular and endovascular surgery 2003-05, Vol.25 (5), p.469-472 |
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| description | Objectives: superficial venous surgery heals chronic venous ulceration (CVU) in the majority of patients with isolated superficial venous reflux (SVR). This study examines the role of superficial venous surgery in patients with comined SVR and segmental deep venous reflux (DVR). Methods: combined SVR and segmental DVR was diagnosed by venous duplex in 53 limbs in 49 patients (24 men and 25 women of median age 66, range 27-90, years). Fourteen limbs had varicose veins (CEAP class 2-4) and 39 (74%) had active CVU (CEAP class 6). Duplex ultrasound was performed before and three months after local anaesthetic superficial venous surgery. Perforator vein surgery, skin grafting and compression bandaging or hosiery were not used. Results: forty-two limbs with long saphenous vein (LSV) reflux underwent sapheno-femoral disconnection, 10 with short saphenous vein (SSV) reflux underwent sapheno-popliteal disconnection and one limb with LSV and SSV reflux had sapheno-femoral and sapheno-popliteal disconnection. Segmental DVR was confined to the superficial femoral vein (SFV) in 16 limbs, below knee popliteal vein (BKPV) in 25 and gastrocnemius vein (GV) in 12 limbs. Overall, duplex demonstrated post-operative resolution of segmental DVR in 26 of 53 (49%) limbs. Resolution of segmental SFV reflux occurred in 12 of 16 (75%) limbs compared with 14 of 37 (38%) limbs with segmental BKPV or GV reflux (p = 0.018). Segmental DVR resolved in 19 of 39 (49%) limbs with CVU and ulcer healing occurred in 30 of 39 (77%) limbs at 12 months with a median time to healing of 61 (range 14-352) days. Segmental DVR resolved in 14 of 30 (47%) limbs with a healed ulcer: 7 of 9 (78%) limbs with SFV and 7 of 21 (33%) with BKPV or GV reflux (p = 0.046). Conclusions: these data demonstrate that in patients with combined SVR and segmental DVR, superficial venous surgery alone corrects DVR in almost 50% of limbs and is associated with ulcer healing in 77% of limbs at 12 months. These findings suggest an extended role for superficial venous surgery in the management of patients with complicated venous disease.
Eur J Vasc Endovasc Surg 25, 469-472 (2003) |
| doi_str_mv | 10.1053/ejvs.2002.1894 |
| format | Article |
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Eur J Vasc Endovasc Surg 25, 469-472 (2003)</description><identifier>ISSN: 1078-5884</identifier><identifier>EISSN: 1532-2165</identifier><identifier>DOI: 10.1053/ejvs.2002.1894</identifier><identifier>PMID: 12713788</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Female ; Humans ; Leg Ulcer - diagnostic imaging ; Leg Ulcer - etiology ; Leg Ulcer - surgery ; Male ; Middle Aged ; Prospective Studies ; Segmental deep venous reflux ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Varicose Ulcer - diagnostic imaging ; Varicose Ulcer - etiology ; Varicose Ulcer - surgery ; Venous Insufficiency - complications ; Venous Insufficiency - diagnostic imaging ; Venous Insufficiency - surgery ; Venous surgery</subject><ispartof>European journal of vascular and endovascular surgery, 2003-05, Vol.25 (5), p.469-472</ispartof><rights>2003 Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-1dd417ebba3b21c0e5169983e3c3388505c53ffbadeef29167d653e795ea15f33</citedby><cites>FETCH-LOGICAL-c380t-1dd417ebba3b21c0e5169983e3c3388505c53ffbadeef29167d653e795ea15f33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1078588402918940$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12713788$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adam, D.J.</creatorcontrib><creatorcontrib>Bello, M.</creatorcontrib><creatorcontrib>Hartshorne, T.</creatorcontrib><creatorcontrib>London, N.J.M.</creatorcontrib><title>Role of superficial venous surgery in patients with combined superficial and segmental deep venous reflux</title><title>European journal of vascular and endovascular surgery</title><addtitle>Eur J Vasc Endovasc Surg</addtitle><description>Objectives: superficial venous surgery heals chronic venous ulceration (CVU) in the majority of patients with isolated superficial venous reflux (SVR). This study examines the role of superficial venous surgery in patients with comined SVR and segmental deep venous reflux (DVR). Methods: combined SVR and segmental DVR was diagnosed by venous duplex in 53 limbs in 49 patients (24 men and 25 women of median age 66, range 27-90, years). Fourteen limbs had varicose veins (CEAP class 2-4) and 39 (74%) had active CVU (CEAP class 6). Duplex ultrasound was performed before and three months after local anaesthetic superficial venous surgery. Perforator vein surgery, skin grafting and compression bandaging or hosiery were not used. Results: forty-two limbs with long saphenous vein (LSV) reflux underwent sapheno-femoral disconnection, 10 with short saphenous vein (SSV) reflux underwent sapheno-popliteal disconnection and one limb with LSV and SSV reflux had sapheno-femoral and sapheno-popliteal disconnection. Segmental DVR was confined to the superficial femoral vein (SFV) in 16 limbs, below knee popliteal vein (BKPV) in 25 and gastrocnemius vein (GV) in 12 limbs. Overall, duplex demonstrated post-operative resolution of segmental DVR in 26 of 53 (49%) limbs. Resolution of segmental SFV reflux occurred in 12 of 16 (75%) limbs compared with 14 of 37 (38%) limbs with segmental BKPV or GV reflux (p = 0.018). Segmental DVR resolved in 19 of 39 (49%) limbs with CVU and ulcer healing occurred in 30 of 39 (77%) limbs at 12 months with a median time to healing of 61 (range 14-352) days. Segmental DVR resolved in 14 of 30 (47%) limbs with a healed ulcer: 7 of 9 (78%) limbs with SFV and 7 of 21 (33%) with BKPV or GV reflux (p = 0.046). Conclusions: these data demonstrate that in patients with combined SVR and segmental DVR, superficial venous surgery alone corrects DVR in almost 50% of limbs and is associated with ulcer healing in 77% of limbs at 12 months. These findings suggest an extended role for superficial venous surgery in the management of patients with complicated venous disease.
Eur J Vasc Endovasc Surg 25, 469-472 (2003)</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Humans</subject><subject>Leg Ulcer - diagnostic imaging</subject><subject>Leg Ulcer - etiology</subject><subject>Leg Ulcer - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Segmental deep venous reflux</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Doppler, Duplex</subject><subject>Varicose Ulcer - diagnostic imaging</subject><subject>Varicose Ulcer - etiology</subject><subject>Varicose Ulcer - surgery</subject><subject>Venous Insufficiency - complications</subject><subject>Venous Insufficiency - diagnostic imaging</subject><subject>Venous Insufficiency - surgery</subject><subject>Venous surgery</subject><issn>1078-5884</issn><issn>1532-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtPwzAQhy0EoqWwMqJMbAl-xLEzooqXVAkJwWw5zqW4ygs7KfS_x1GLEAOTfdZ3vzt_CF0SnBDM2Q1stj6hGNOEyDw9QnPCGY0pyfhxuGMhYy5lOkNn3m8wxpwwfopmhArChJRzZF-6GqKuivzYg6ussbqOttB2ow9Pbg1uF9k26vVgoR189GmH98h0TWFbKP806TbUsG4CFqoSoP_JcVDV49c5Oql07eHicC7Q2_3d6_IxXj0_PC1vV7FhEg8xKcuUCCgKzQpKDAZOsjyXDJhhTEqOueGsqgodJlQ0J5koM85A5Bw04RVjC3S9z-1d9zGCH1RjvYG61i2EbZRgNE2ZSAOY7EHjOu_Dkqp3ttFupwhWk1w1yVWTXDXJDQ1Xh-SxaKD8xQ82AyD3AIT_bS045U3QZqC0Dsygys7-l_0NXlSLMw</recordid><startdate>20030501</startdate><enddate>20030501</enddate><creator>Adam, D.J.</creator><creator>Bello, M.</creator><creator>Hartshorne, T.</creator><creator>London, N.J.M.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030501</creationdate><title>Role of superficial venous surgery in patients with combined superficial and segmental deep venous reflux</title><author>Adam, D.J. ; Bello, M. ; Hartshorne, T. ; London, N.J.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-1dd417ebba3b21c0e5169983e3c3388505c53ffbadeef29167d653e795ea15f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Humans</topic><topic>Leg Ulcer - diagnostic imaging</topic><topic>Leg Ulcer - etiology</topic><topic>Leg Ulcer - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Segmental deep venous reflux</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Doppler, Duplex</topic><topic>Varicose Ulcer - diagnostic imaging</topic><topic>Varicose Ulcer - etiology</topic><topic>Varicose Ulcer - surgery</topic><topic>Venous Insufficiency - complications</topic><topic>Venous Insufficiency - diagnostic imaging</topic><topic>Venous Insufficiency - surgery</topic><topic>Venous surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adam, D.J.</creatorcontrib><creatorcontrib>Bello, M.</creatorcontrib><creatorcontrib>Hartshorne, T.</creatorcontrib><creatorcontrib>London, N.J.M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adam, D.J.</au><au>Bello, M.</au><au>Hartshorne, T.</au><au>London, N.J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of superficial venous surgery in patients with combined superficial and segmental deep venous reflux</atitle><jtitle>European journal of vascular and endovascular surgery</jtitle><addtitle>Eur J Vasc Endovasc Surg</addtitle><date>2003-05-01</date><risdate>2003</risdate><volume>25</volume><issue>5</issue><spage>469</spage><epage>472</epage><pages>469-472</pages><issn>1078-5884</issn><eissn>1532-2165</eissn><abstract>Objectives: superficial venous surgery heals chronic venous ulceration (CVU) in the majority of patients with isolated superficial venous reflux (SVR). This study examines the role of superficial venous surgery in patients with comined SVR and segmental deep venous reflux (DVR). Methods: combined SVR and segmental DVR was diagnosed by venous duplex in 53 limbs in 49 patients (24 men and 25 women of median age 66, range 27-90, years). Fourteen limbs had varicose veins (CEAP class 2-4) and 39 (74%) had active CVU (CEAP class 6). Duplex ultrasound was performed before and three months after local anaesthetic superficial venous surgery. Perforator vein surgery, skin grafting and compression bandaging or hosiery were not used. Results: forty-two limbs with long saphenous vein (LSV) reflux underwent sapheno-femoral disconnection, 10 with short saphenous vein (SSV) reflux underwent sapheno-popliteal disconnection and one limb with LSV and SSV reflux had sapheno-femoral and sapheno-popliteal disconnection. Segmental DVR was confined to the superficial femoral vein (SFV) in 16 limbs, below knee popliteal vein (BKPV) in 25 and gastrocnemius vein (GV) in 12 limbs. Overall, duplex demonstrated post-operative resolution of segmental DVR in 26 of 53 (49%) limbs. Resolution of segmental SFV reflux occurred in 12 of 16 (75%) limbs compared with 14 of 37 (38%) limbs with segmental BKPV or GV reflux (p = 0.018). Segmental DVR resolved in 19 of 39 (49%) limbs with CVU and ulcer healing occurred in 30 of 39 (77%) limbs at 12 months with a median time to healing of 61 (range 14-352) days. Segmental DVR resolved in 14 of 30 (47%) limbs with a healed ulcer: 7 of 9 (78%) limbs with SFV and 7 of 21 (33%) with BKPV or GV reflux (p = 0.046). Conclusions: these data demonstrate that in patients with combined SVR and segmental DVR, superficial venous surgery alone corrects DVR in almost 50% of limbs and is associated with ulcer healing in 77% of limbs at 12 months. These findings suggest an extended role for superficial venous surgery in the management of patients with complicated venous disease.
Eur J Vasc Endovasc Surg 25, 469-472 (2003)</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>12713788</pmid><doi>10.1053/ejvs.2002.1894</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Female Humans Leg Ulcer - diagnostic imaging Leg Ulcer - etiology Leg Ulcer - surgery Male Middle Aged Prospective Studies Segmental deep venous reflux Treatment Outcome Ultrasonography, Doppler, Duplex Varicose Ulcer - diagnostic imaging Varicose Ulcer - etiology Varicose Ulcer - surgery Venous Insufficiency - complications Venous Insufficiency - diagnostic imaging Venous Insufficiency - surgery Venous surgery |
| title | Role of superficial venous surgery in patients with combined superficial and segmental deep venous reflux |
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