Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: Lessons learned from the North American Subfascial Endoscopic Perforator Surgery registry

Gloviczki, Péter; Bergan, John J.; Rhodes, Jeffrey M.; Canton, Linda G.; Harmsen, Scott; Ilstrup, Duane M.

doi:10.1016/s0741-5214(99)70278-8

Cited by 288 publications

(237 citation statements)

References 35 publications

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“…A multicenter study involving 148 SEPS procedures in patients with active and healed venous ulcers demonstrated accumulative ulcer healing of 88% at 1 year and an ulcer recurrence of 28% at 2 years. 83 SEPS also can be used in conjunction with superficial vein ablation with 91% ulcer healing at a mean of 2.9 months, and is accompanied by a significant improvement in the clinical severity and venous disability scores. 84 In a large study evaluating 832 patients with CEAP clinical classes 4 to 6 for 9 years, 55% of patients underwent both SEPS and ligation and stripping of the superficial venous segments.…”

Section: Subfascial Endoscopic Perforator Surgerymentioning

confidence: 99%

Chronic Venous Insufficiency

2005

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C hronic venous disease is often overlooked by primary and cardiovascular care providers because of an underappreciation of the magnitude and impact of the problem. The importance of chronic venous disease is related to the number of people with the disease and the socioeconomic impact of its more severe manifestations. Unfortunately, the literature concerning the prevalence and incidence of chronic venous disease has varied greatly because of differences in the methods of evaluation, criteria for definition, and the geographic regions analyzed. The most common manifestations of chronic venous disease are dilated cutaneous veins, such as telangiectases and reticular veins, and varicose veins. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling, edema, skin changes, and ulcerations. Although the term CVI is often used to exclude uncomplicated varicose veins, varicose veins have incompetent valves with increased venous pressure leading to progressive dilation and tortuosity. We will use the term CVI to represent the full spectrum of manifestations of chronic venous disease.Varicose veins have an estimated prevalence between 5% to 30% in the adult population, with a female to male predominance of 3 to 1, although a more recent study supports a higher male prevalence. 1 The Edinburgh Vein Study screened 1566 subjects with duplex ultrasound for reflux finding CVI in 9.4% of men and 6.6% of women, after age adjustment, which rose significantly with age (21.2% in men Ͼ50 years old, and 12.0% in women Ͼ50 years old). 2 The San Valentino Vascular Screening Project found among the 30 000 subjects evaluated by clinical assessment and duplex ultrasound a prevalence of 7% for varicose veins and 0.86% for "symptomatic" CVI. 3 As in previous studies, CVI was more common with increasing age, but there was no significant sex difference. The rate of varicose vein development may be estimated from the Framingham Heart Study, which found an annual incidence of 2.6% in women and 1.9% in men. 4 Risk factors found to be associated with CVI include age, sex, a family history of varicose veins, obesity, pregnancy, phlebitis, and previous leg injury. 5,6 There also may be environmental or behavioral factors associated with CVI such as prolonged standing and perhaps a sitting posture at work. 6,7 Varicose veins have a significant impact on healthcare resources, with millions of people seeking medical attention for their cosmetic appearance annually. Although often minimized, the cosmetic consequences may adversely affect an individual's quality of life and are associated with other manifestations.The more serious consequences of CVI such as venous ulcers have an estimated prevalence of Ϸ0.3%, although active or healed ulcers are seen in Ϸ1% of the adult population. 8 It has been estimated that Ϸ2.5 million people have CVI in the United States, and of those, Ϸ20% develop venous ulcers. 9 The ov...

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Section: Subfascial Endoscopic Perforator Surgerymentioning

confidence: 99%

Chronic Venous Insufficiency

2005

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“…Since its first description by Hauer in the 1980s, 1) SEPS has been accepted as an improved treatment modality in the surgical treatment of perforating vein insufficiency, particularly in cases with advanced skin changes. SEPS is performed in some facilities in North America [2][3][4][5] and Europe [6][7][8][9][10] as a component of the comprehensive treatment program for venous insufficiency. These previous studies presented favorable results with SEPS.…”

Section: Introductionmentioning

confidence: 99%

Subfascial Endoscopic Perforator Surgery Using Screw-Type Ports Is a Very Useful Component of a Comprehensive Treatment Program for Chronic Venous Insufficiency

Kusagawa¹,

Shomura²,

Komada³

et al. 2012

Annals of Vascular Diseases

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“…The procedure is associated with much less scarring and a faster recovery than the open method. The North American registry confirmed a low 2-year recurrence rate of venous ulcers and a more rapid ulcer healing with the laparoscopic method of perforator interruption [10]. In a recent study using subfascial balloon dissection and interruption of incompetent perforating veins (usually in conjunction with great saphenous vein ligation and stripping), 92 % of patients exhibited significant improvement of venous stasis ulcers within 4-14 weeks [11].…”

Section: Discussionmentioning

confidence: 91%

Taking Up Subfascial Endoscopic Perforator Surgery for Patients of Lower Limb Varicose Veins with Below Knee Perforators, in A Government Medical College–A Review of Eleven Cases

2012

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Varicose veins are the most common manifestation of chronic venous insufficiency (CVI) worldwide. They interfere with the patients' daily activities and hamper their professional endeavors, and therefore need to be addressed at the earliest with the best tools. Eleven patients of varicose veins of the lower limb with below knee perforators underwent subfascial endoscopic perforator surgery (SEPS) from October 2010 to December 2011 in our institute. The procedure was successfully completed in all 11 patients. The mean operating time was 78 min (60-96 min). The results showed a favorable outcome for the patients in terms of faster recovery and less morbidity.

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Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: Lessons learned from the North American Subfascial Endoscopic Perforator Surgery registry

Cited by 288 publications

References 35 publications

Chronic Venous Insufficiency

Chronic Venous Insufficiency

Subfascial Endoscopic Perforator Surgery Using Screw-Type Ports Is a Very Useful Component of a Comprehensive Treatment Program for Chronic Venous Insufficiency

Taking Up Subfascial Endoscopic Perforator Surgery for Patients of Lower Limb Varicose Veins with Below Knee Perforators, in A Government Medical College–A Review of Eleven Cases

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