Tratamento da recidiva da crossa da veia safena magna por acesso proximal

Abstract

The most common cause of recurrence of varicose veins in the lower limbs is inadequate dissection of the internal saphenous arch, with ligature that is not flush to the saphenofemoral junction. Direct access to the scar tissue of previous surgery should be avoided to the maximum because of the high risk of bleeding and of lymphatic injuries. Access proximal to the scar tissue, initially at the common femoral vein, above the saphenofemoral junction, continuing caudally to the saphenous arch, proved to be an effective and relatively simple technique when compared to medial, lateral and direct approaches.Keywords: saphenous vein; recurrence; varicose veins. ResumoA maior causa de recidiva das varizes dos membros inferiores é a inadequada dissecção da crossa da safena interna, com a ligadura não rente da junção safenofemoral. O acesso direto ao tecido cicatricial de uma cirurgia prévia deve ser evitado ao máximo pelo elevado risco de sangramento e de lesões linfáticas. O acesso proximal ao tecido cicatricial, abordando inicialmente a veia femoral comum acima da junção safenofemoral, seguindo-a em direção caudal até a crossa da safena, mostrou-se uma técnica eficiente e relativamente simples quando comparada às abordagens medial, lateral e direta.

CHIVA to treat saphenous vein insufficiency in chronic venous disease: Characteristics and results

“…A Brazilian study presented good results after open correction for groin recurrence, although complications such as skin infection, lymphedema, and recurrence are a matter of concern. 28 Sclerotherapy has a good success rate and is being increasingly used worldwide, but deep vein thrombosis and recurrence are possible complications. Recurrence is common after saphenous stripping and tends to increase with time elapsed after the operation.…”