Surgical methods and clinical results of subfascial endoscopic perforator surgery in Japan

Kusagawa, Hitoshi; Haruta, Naoki; Shinhara, Ryo; Hoshino, Yuji; Tabuchi, Atsushi; Sugawara, Hiromitsu; Shinozaki, Koji; Matsuzaki, Kei; Nagata, Hidetoshi; Niihara, Hiroyuki; Kohno, Kunie; Takeda, Ryoji

doi:10.1177/0268355517750523

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…Endovenous laser treatment (EVLT) is also one of the minimally invasive methods of endovenous treatment. The principle of treatment is to use the thermal effect released by the laser to damage the venous endothelium, damage the vein wall, and deposit thrombosis to occlude the varicose vein, which in turn obliterates the vena cava [ 9 , 10 ]. At present, most patients in clinical practice generally require combined treatment due to etiology, symptoms, severity, and other reasons.…”

Section: Introductionmentioning

confidence: 99%

Study of Subfascial Endoscopic Perforator Surgery Combined with Endovenous Laser Treatment in the Treatment of Great Saphenous Varicose Veins

Wang

Zhang

2022

Journal of Healthcare Engineering

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Great saphenous varicose vein (GSVV) is a venous reflux disease of the lower extremity. In order to explore the clinical effect of subfascial endoscopic perforator surgery (SEPS) with endovenous laser treatment (EVLT) in the treatment of GSVV, 80 patients who underwent unilateral saphenous varicose surgery are analyzed. The operation results show that the patients who used SEPS + EVLT have less operation time and mean blood loss, shorter postoperative active time and hospitalization stay, better curative effect, and higher notch aesthetics P < 0.05 . SEPS combined with EVLT has a remarkable curative effect in the treatment of saphenous varicose veins of lower extremity, which can significantly shorten the hospitalization time of patients and improve the coagulation index and stress index.

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Section: Introductionmentioning

confidence: 99%

Study of Subfascial Endoscopic Perforator Surgery Combined with Endovenous Laser Treatment in the Treatment of Great Saphenous Varicose Veins

Wang

Zhang

2022

Journal of Healthcare Engineering

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“…9 Gonza´lez et al designed a noninferiority study between RF, HLS and conservative hemodynamic cure on 225 subjects. 12 RF was found 15 Primary VLU healing rate was reported as 96.2%, with a 12% recurrence rate. SEPS significantly decreased VCSSs from 10.0 � 6.6 to 3.1 � 3.4.…”

Section: Discussionmentioning

confidence: 92%

“…evaluated 1287 limbs of 1091 subjects that underwent SEPS (average follow-up was 47.7 months). 15 Primary VLU healing rate was reported as 96.2%, with a 12% recurrence rate. SEPS significantly decreased VCSSs from 10.0 ± 6.6 to 3.1 ± 3.4.…”

Section: Discussionmentioning

confidence: 97%

Comparison of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers: Retrospective cohort with five-year follow-up

2021

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Objective To compare the use of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers. Methods One hundred ninety-five ( n = 195) subjects who were treated for venous leg ulcers were enrolled between 2009 and 2014. Three groups were formed (Group A: high saphenous ligation and total stripping, Group B: radiofrequency ablation of the great saphenous vein + perforators, and Group C: radiofrequency ablation of the great saphenous vein + subfascial endoscopic perforator surgery) ( n = 65 for each group). The venous clinical severity score for baseline, 1st, 6th, and 12th months, great saphenous vein occlusion at the 1st, 6th, and 12th months, and ulcer rates for the 1st, 2nd, 3rd, 4th, and 5th years were recorded. Results For venous clinical severity score, only the first month decrease was significant for the subfascial endoscopic perforator surgery group ( p = 0.001). Great saphenous vein occlusion was higher at the 6th and 12th months for the high saphenous ligation and stripping and subfascial endoscopic perforator surgery groups than for the radiofrequency ablation group ( p = 0.036 and p = 0.037). The rate of ulcers for the subfascial endoscopic perforator surgery group was lower at the second, third, fourth, and fifth years ( p = 0.011). No significant difference was found between groups for the five-year recovery rates ( p > 0.05). Conclusion Subfascial endoscopic perforator surgery technique in conjunction with radiofrequency ablation of axial vein was superior to both high saphenous ligation and stripping and radiofrequency ablation of axial and perforators for ulcer healing.

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“…Moreover, Dodd (UIP name 1) : perforating veins of the femoral canal, 5.1.1) and Boyd perforators (UIP name: paratibial perforator veins, 3.1.1) are considered clinically significant because of their association with the great saphenous veins, and Cockett perforators (UIP name: posterior tibial perforator veins, 3.1.2) are considered clinically significant because of their association with lower leg stasis skin lesions. 2) In addition to direct ligation and resection, 3,4) subfascial endoscopic perforator surgery [5][6][7] and endovascular ablation, 8) sclerotherapy, 9) and glue treatment, 10) which are covered by insurance in Japan, have been reported for these typical perforator refluxes. On the contrary, approximately 90 perforator branches in the lower extremities have been reported, 11) and although atypical IPVs have not gained attention, some reports have analyzed the results of vein echocardiography as part of the pathophysiology referred to as nonsaphenous superficial vein (NSV) reflux, varicose veins without truncal saphenous reflux, and varicose veins with competent saphenous trunks, and it has been suggested that observing not only saphenous veins but also other veins and not overlooking the findings are essential for the accurate treatment of lower extremity varicose veins.…”

Section: Discussionmentioning

confidence: 99%

Surgery for Varicose Veins Caused by Atypical Incompetent Perforating Veins

Kusagawa¹

2019

Annals of Vascular Diseases

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Objective: To clarify the localization of and surgery for atypical incompetent perforating veins (IPVs) other than Dodd, Boyd, Cockett perforators, which have not been previously discussed. Methods: Forty-three atypical IPVs, diagnosed by venous ultrasonography and treated surgically from January 2014 to June 2018, were analyzed from the viewpoint of localization and surgical treatment. Results: All atypical IPVs passed through the fascia in the area between the muscle compartments in the same way as the typical IPV. The IPVs were most commonly located in the posterolateral part of the lower thigh (16), around the popliteal fossa (9), and in the posterolateral part in the lower calf (7). For 42 IPVs, surgery consisted of direct ligation and resection at the fascia level, and foam sclerotherapy was performed for 1 IPV. The blood flow of the perforating vein was blocked under the fascia in 40 IPVs, but to and fro flow at the fascia level remained in 3 IPVs. Conclusion: Atypical IPVs causing varicose veins were most common in the posterolateral part of the lower thigh. For treatment, it is important to ligate and cut them without leaving stumps with related branches outside the fascia under precise ultrasonic observation. (This is a translation of

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Surgical methods and clinical results of subfascial endoscopic perforator surgery in Japan

Abstract: These results indicate that subfascial endoscopic perforator surgery is an alternative to improve the long-lasting disease severity and/or clinical outcome.

Cited by 12 publications

References 33 publications

Study of Subfascial Endoscopic Perforator Surgery Combined with Endovenous Laser Treatment in the Treatment of Great Saphenous Varicose Veins

Study of Subfascial Endoscopic Perforator Surgery Combined with Endovenous Laser Treatment in the Treatment of Great Saphenous Varicose Veins

Comparison of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers: Retrospective cohort with five-year follow-up

Surgery for Varicose Veins Caused by Atypical Incompetent Perforating Veins

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