Early experience of transilluminated cryosurgery for varicose vein with saphenofemoral reflux: review of 84 patients (131 limbs)

Abstract

PurposeVaricose veins with great saphenous vein (GSV) insufficiency is prevalent. Among various surgical treatments for varicose veins, cryosurgery of GSV is an alternative minimally invasive technique that could leave fewer scars and replace conventional stripping with ambulatory phlebectomy. This study sought to assess outcomes including efficacy and safety of cryosurgery for varicose veins.MethodsOne hundred thirty-one limbs in 84 patients (37 male, 47 female; mean age, 53.3 years) with varicose veins were treated with cryosurgery over a 2-year period. The patients were followed for postoperative complication with surveillance of recurrence. The analyzed variables included age, sex, symptom, operative time (from skin incision to the application of elastic bandages on the legs for compression purposes), and postoperative complications including bruising, hematoma, superficial thrombophlebitis, cellulitis, seroma, cutaneous nerve damage, and wound complication.ResultsThe mean operative time was 64.7 minutes for both limbs and 44 minutes for single limbs. The median number of incisions was 2. For stripping of GSV, one incision at the groin was necessary. Postoperative complications included an episode of hematoma in 3 limbs (2.3%), cutaneous nerve damage in 3 limbs (2.3%), cellulitis in 2 patients (1.5%), and seroma in 1 limb (0.8%). No wound infection, thrombophlebitis or deep venous thrombosis was observed. During follow-up (mean follow-up period, 13.5 months; range, 3–28 months), there was no recurrence.ConclusionCryosurgery to treat varicose veins is an effective and safe treatment modality in terms of postoperative complication, cosmetic result, and recurrence.

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

“…We did not encounter cellulitis, superficial thrombophlebitis, wound infection, seroma or lymphoedema. Comparing our data to a previous study [ 6 ], bruising (32.38% vs. 64.9%) and haematomas (2.02% vs. 2.3%) were observed in a lower percentage. An explanation for this may be the conversion of antiplatelet drug treatment to heparins in the cases which undergone outpatient antiplatelet drug treatment.…”

“…However, several complications have been noticed. According to literature, complications after this procedure may vary from postoperative pain, skin pigmentation, bruising, haematoma, lymphatic complications (lymphoedema), cellulitis, superficial thrombophlebitis, wound infection, deep vein thrombosis, and cutaneous nerve damage with paraesthesia [ 6 , 16 , 17 ]. Postoperative pain and bruising are the major short-term side effects reported, and may appear after EVLT, as well [ 18 ].…”

“…Cryostripping is a minimally invasive surgical method used in varicose vein ablation, and is an effective and safe treatment modality in terms of postoperative complications, cosmetic results, and recurrence [ 6 ]. Curing varicose veins by cryostripping was practised for the first time in 1987, and since 1990 it has been successfully used in some phlebological centres in Germany.…”

Effectiveness of tumescent solution combined with negative pressure wound therapy in traditional high ligation and stripping of the great saphenous vein

“…[ 11 – 13 ] According to previous literature, postoperative subcutaneous ecchymosis can reach to approximately 80%. [ 14 ] Postoperative complications, such as pain and ecchymosis, are not serious disorders, which can be alleviated or cured by appropriate treatment. However, these complications could prolong the hospitalization time of patients, increase medical burden, greatly affect patients’ medical experience, exert a certain impact on patients’ psychology, and even become the disputed point of doctor–patient contradiction.…”

Nerve Injury in venous procedures: Malpractice, characteristics, and strategies to avoid it

“…Removal of the vein is obtained by withdrawing the probe in the direction of the entrance. A retrospective noncomparative study with a total of 84 patients (131 limbs) with varicose veins with GSV incompetence was treated with cryosurgery over a 2 year period showed cutaneous nerve damage -defined as numbness and paresthesia -in 3 limbs (2.3%) 42 .…”