Angioscopic External Valvuloplasty in the Treatment of Varicose Veins

Satokawa, Hirono; Hoshino, Shunichi; Igari, Tsuguo; Takase, Shinya; Ogawa, Tomohiro

doi:10.1177/026835559701200404

Cited by 22 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are discrepancies in the literature relating to the applicability of the technique. 12 Corcos et al13 found that the valvuloplasty technique was applicable in only 8.2% of varicose vein cases and 63.3% of early varicose veins. This may be explained by patient selection.…”

Section: Discussionmentioning

confidence: 99%

The Treatment of Varicose Veins with External Stentding to the Saphenofemoral Junction

Lane

Cuzzilla

Coroneos

2002

Vasc Endovascular Surg

View full text Add to dashboard Cite

Presented are the experiences with 1,516 external valvular stents (Venocufft and Venocuff II) implanted at the saphenofemoral junction (SFJ) between 1985 and 2000. To assess the applicability of the procedure it was found that the appropriate implantation was performed in 34% of 310 consecutive venous procedures. To assess patient preference between external valvular stenting and simultaneous contralateral stripping, 56 consecutive patients were followed up at 3 months postoperatively. Four percent preferred stripping, 4% had no preference, and 92% preferred Venocuff IItrade mark implantation. Competence at the SFJ with specific duplex ultrasound indicators was 94% at 3 months (n = 100) and 90% at 4.8 years (n = 107). Minimal residual reflux (less than 50 mL/minute with maximum Valsalva) was present in the remainder but did not produce symptoms and very rarely progressed over the mean time of 5 years. The internal diameter (ID) of the long saphenous vein (LSV), 3 cm distal to the SFJ, changed from 7.6 +/- 2.3 mm to 4.9 +/- 1.1 mm (p < 0.001) and at the knee from 6.9 +/- 1.9 mm to 3.7 +/- 1.0 mm (p < 0.001). Patients presenting with underlying deep venous disease began with significantly higher ID, ie, 9.0 +/- 2.1 mm at the upper end of the LSV and 7.1 +/- 2.0 mm at the knee, but postoperatively the IDs reverted to those of postoperative patients with a normal deep venous system. To assess patients with recurrences, 366 limbs had simultaneous stripping and contralateral SFJ repair with the Venocuff II. Of these 33 (9%) had recurrences at 4.9 years, 82% of them on the stripping side, and on the repair side half of the recurrences had a competent SFJ (9%). Limbs with an incompetent lateral or anterior accessory system, with an incompetent SFJ (168), were compared with 11 matched randomized controls where stripping was performed. The recurrence rate was 1.2% versus 36% on the strip side. The follow-up for these cases was 6.4 years. Pregnancy (n = 14) produces a high recurrence rate, but stripping and valve repairs were not significantly different, ie, despite small numbers, there was a very strong tendency toward higher recurrence rates on the stripped side. The complication rate was small and the cost of the device is low. The method allows a repairable nonablative approach that can be offered in patients where no other surgical treatment can or should be offered. External stenting to the SFJ is the preferred option for early to moderate varicose veins involving the LSV where the clinical and ultrasonic indicators have been fulfilled.

show abstract

Section: Discussionmentioning

confidence: 99%

The Treatment of Varicose Veins with External Stentding to the Saphenofemoral Junction

Lane

Cuzzilla

Coroneos

2002

Vasc Endovascular Surg

View full text Add to dashboard Cite

show abstract

“…14,15 The patients comprised 28 males and 60 females, ranging in age from 29 to 79 years (mean 55.8 years). 14,15 The patients comprised 28 males and 60 females, ranging in age from 29 to 79 years (mean 55.8 years).…”

Section: Methodsmentioning

confidence: 99%

“…Angioscopic valvular incompetence was classified into three types and valvuloplasty was applied in valves with type I or type II: 14,15 Type I: valves with elongated and atrophic cusps. A bloodless field was obtained by manually flushing normal saline through a flush channel.…”

Section: Methodsmentioning

confidence: 99%

Great Saphenous Vein Sparing Surgery by Angioscopic Valvuloplasty Combined with Axial Transposition of a Competent Tributary Vein – 5-Year Follow-Up

Yamaki¹,

Nozaki²,

Sakurai³

et al. 2009

Journal of Vascular Surgery

View full text Add to dashboard Cite

Objectives:To identify predictive factors causing mortality in patients with injuries to the portal (PV) and superior mesenteric veins (SMV).Design: Retrospective analysis of prospectively collected data. Materials and methods: Adults admitted with blunt or penetrating PV and SMV injuries at an academic level I trauma center during a 20-year period.Results: Of 26,387 major trauma victims admitted from 1987 through 2006, 26 sustained PV or SMV injuries (PV ϭ 15, SMV ϭ 11). Mechanism of injury was penetrating in 19 (73%) and 20 were in shock. Active hemorrhage occurred in 21. Most patients had associated injuries (2.9 Ϯ 1.8/ patient). Mean Injury Severity Score (ISS) was 27.8 Ϯ 16.8. All PV injuries underwent suture repair and 27% of SMV injuries were ligated. Overall mortality was 46% (PV ϭ 47%, SMV ϭ 45%). Stab wounds had a lower mortality (31%) compared to gunshot wounds (67%) and blunt injuries (57%). Nonsurvivors had a higher ISS (35.8 vs. 20.9; p ϭ 0.02), more associated injuries (3.7 vs. 2.2; p ϭ 0.02), were older, and had active hemorrhage. Active hemorrhage (p ϭ 0.04) was independently related to death while shock on admission (odds ratio ϭ 6.1, p ϭ 0.61) trended toward higher mortality.Conclusion: Despite improvements in trauma care, mortality of PV and SMV injuries remains high. Shock, active hemorrhage, and associated injuries were predictive of increased mortality.

show abstract

“…A bloodless field was obtained by manually flushing normal saline through a flush channel. Angioscopic external valvuloplasty was performed as described by Hoshino et al, 14,15 with plication of the commissure from outside the vein wall using 7-0 polypropylene (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

Preliminary Report of a New Approach to Sparing the Greater Saphenous Vein for Grafting: Valvuloplasty Combined with Axial Transposition of a Competent Tributary Vein

2001

View full text Add to dashboard Cite

show abstract

Angioscopic External Valvuloplasty in the Treatment of Varicose Veins

Cited by 22 publications

References 10 publications

The Treatment of Varicose Veins with External Stentding to the Saphenofemoral Junction

The Treatment of Varicose Veins with External Stentding to the Saphenofemoral Junction

Great Saphenous Vein Sparing Surgery by Angioscopic Valvuloplasty Combined with Axial Transposition of a Competent Tributary Vein – 5-Year Follow-Up

Preliminary Report of a New Approach to Sparing the Greater Saphenous Vein for Grafting: Valvuloplasty Combined with Axial Transposition of a Competent Tributary Vein

Contact Info

Product

Resources

About