Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

Abstract

ObjectiveThe aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV) insufficiency.MethodsExternal valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes.ResultsA complete clinical and radiological healing was observed in 50 patients (60%). In 13 cases (15.6%), a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6%) developed superficial vein thrombosis, and only one patient (1.2%) developed deep vein thrombosis. Contact was lost from 32 patients (38.5%) for different reasons.ConclusionExternal valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping.

Functional repair of the great saphenous vein by external valvuloplasty reduces the vein's diameter: 6-month results of a multicentre study

“… 17 Sarac et al. 18 also found a decreased diameter of the great saphenous vein at the saphenofemoral junction. The authors described a significant reduction from 5.6 mm preoperatively to 3.1 mm postoperatively on the first postoperative day.…”

“…Seven years after the treatment, the authors reported a mean diameter at the saphenofemoral junction of 4.5 mm, but did not state the significance level. 18 Geier et al. 15 measured the diameter of the great saphenous vein in their study with a 5-year follow-up.…”

“…used a polytetrafluoroethylene (PTFE)-covered nitinol frame, and Lane et al. 18 , 19 used a specially designed “exostent” device. Only the methods of Joh et al.…”

“…Overall, this was an intention-to treat-analysis, and we evaluated 210 patients from five vein centres, which is a strength of this study. In contrast to other studies, 15 , 17 , 18 we measured the diameter of the great saphenous vein over its entire length at predefined measurement points, which represents another advantage.…”

“… 14 However, this procedure is limited to approximately 15% of all varicose veins patients. 15 Although excellent long-term results with a recurrence rate of 4.6% after 68.5 months and improved venous hemodynamics have been described after eVP, 17 – 19 there is a lack of data because most studies are single-centre. 20 Therefore, we performed this prospective multicentre study involving five high-volume vein centres in Germany.…”