Clinical, ultrasonographic and histological findings in varicose vein surgery

Abstract

SUMMARY OBJECTIVE This study aims to correlate the demographic data, different clinical degrees of chronic venous insufficiency (CEAP), ultrasound findings of saphenofemoral junction (SFJ) reflux, and anatomopathological findings of the proximal segment of the great saphenous vein (GSV) extracted from patients with primary chronic venous insufficiency (CVI) submitted to stripping of the great saphenous vein for the treatment of lower limb varicose. METHOD This is a prospective study of 84 patients (110 limbs) who were submitted to the stripping of the great saphenous vein for the treatment of varicose veins of the lower limbs, who were evaluated for CEAP clinical classification, the presence of reflux at the SFJ with Doppler ultrasonography, and histopathological changes. We study the relationship between the histopathological findings of the proximal GSV withdrawal of patients with CVI with a normal GSV control group from cadavers. RESULTS The mean age of the patients was higher in the advanced CEAPS categories when comparing C2 (46,1 years) with C4 (55,7 years) and C5-6(66 years), as well as C3 patients (50,6 years) with C5-6 patients. The normal GSV wall thickness (mean 839,7 micrometers) was significantly lower than in the saphenous varicose vein (mean 1609,7 micrometers). The correlational analysis of reflux in SFJ with clinical classification or histopathological finding did not show statistically significant findings. CONCLUSIONS The greater the age, the greater the clinical severity of the patients. The GSV wall is thicker in patients with lower limb varicose veins, but those histopathological changes are not correlated with the disease’s clinical severity or reflux in the SFJ on a Doppler ultrasound.

Polidocanol-foam treatment of varicose veins: Quality-of-life impact compared to conventional surgery

“…Assessing the improvement in VV symptoms is complex, as VV symptoms are not pathognomonic, have poor correlations with anatomical and imaging parameters, and are strongly associated with psychological aspects. 5 A robust correlation between quality of life and the clinical outcome of surgical VV treatment has already been demonstrated. 6 …”

Avaliação do coto residual após 12 meses de safenectomia sem ligadura alta da junção safeno-femoral

“…As varizes de membros inferiores afetam cerca de 35-50% da população brasileira [1][2][3][4] e são um motivo comum para a procura de atendimento médico. Apesar de sua natureza benigna, apresentam importante impacto na qualidade de vida e na área socioeconômica por despesas com cuidados de saúde e dias de trabalho perdidos 3,5,6 .…”

“…Lower limb varicose veins affect around 35-50% of the Brazilian population 1 - 4 and are a common reason for seeking medical care. Although benign, they have a considerable impact on quality of life and significant socioeconomic implications, in terms of healthcare costs and days absent from work.…”

“…From 60 to 80% of patients with varicose veins have reflux at the saphenofemoral junction (SFJ), 1 and the European Society for Vascular Surgery (ESVS) chronic venous insufficiency (CVI) guidelines recommend surgical treatment rather than conservative management for uncomplicated varicose veins. 7 For many years, the gold standard for surgical treatment of symptomatic CVI with great saphenous vein (GSV) insufficiency was conventional surgery with high ligation of SFJ tributaries, followed by removal of the GSV by stripping.…”

“…Entre 60 a 80% dos pacientes com varizes apresentam refluxo na junção safeno-femoral (JSF) 1 , sendo que o guideline de insuficiência venosa crônica (IVC) da Sociedade Europeia de Cirurgia Vascular (SECV) recomenda o tratamento cirúrgico ao invés do conservador para varizes não complicadas 7 . O padrão-ouro para a cirurgia da IVC sintomática com insuficiência da veia safena magna (VSM) foi por muitos anos a cirurgia convencional realizada com a ligadura alta das tributárias da JSF, seguida da retirada da VSM por eversão 6 , 8 .…”