Neovascularization: An “innocent bystander” in recurrent varicose veins

Egan, Bridget; Donnelly, Michael B.; Bresnihan, Mary; Tierney, Sean; Feeley, Martin

doi:10.1016/j.jvs.2006.08.017

Cited by 57 publications

(51 citation statements)

References 30 publications

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“…A controversial topic in varicose vein treatment is the importance of neovascularization, which has been described as either the principal cause of recurrence or an innocent bystander 6,19 . The prevailing definition is the presence of tortuous new veins in a previously obliterated area such as the SFJ or SPJ 20 .…”

Section: Discussionmentioning

confidence: 99%

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Late follow-up of a randomized trial of routine duplex imaging before varicose vein surgery

Blomgren

Johansson

Emanuelsson

et al. 2011

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

“…One reason is inadequate surgery owing to inadequate preoperative investigation 4 . The use of duplex ultrasound imaging before surgery has increased 5,6 . Duplex imaging is time-consuming and costly, and so in some hospitals it is restricted to patients with recurrent varicose veins or severe skin change.…”

Section: Introductionmentioning

confidence: 99%

Late follow-up of a randomized trial of routine duplex imaging before varicose vein surgery

Blomgren

Johansson

Emanuelsson

et al. 2011

British Journal of Surgery

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“…More recently, the importance of neovascularisation has been challenged by Egan et al, who reported that it only occurred in 8% of 500 patients with recurrence. 9 However, they reported a high incidence of GSV stump incompetence (38%) with a persisting incompetent GSV in 44% of thighs. They therefore concluded that neovascularisation was not the real criminal but rather an 'innocent bystander'.…”

Section: Significance Of Neovascularisationmentioning

confidence: 95%

“…The importance of neovascularisation, which is the development of newly formed venous channels draining into the femoral vein in the region of the previously ligated saphenofemoral junction (SFJ), has been established by many authors. [5][6][7][8] On the other hand, Egan et al saw neovascularisation as an 'innocent bystander' 9 (ie a finding on duplex imaging that was incidental to the real cause of recurrence).…”

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confidence: 99%

Neovascularisation is not an Innocent Bystander in Recurrence after Great Saphenous Vein Surgery

Corbett

Prakash

2015

annals

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INTRODUCTION This study sought to establish the causes of failure of great saphenous vein surgery among patients in whom there was confidence that accurate saphenofemoral ligation had been carried and the great saphenous vein had been stripped at least to knee level. METHODS This was an observational study of 100 limbs (66 patients) operated on by a single surgeon 5-22 years previously (mean: 12 years). The index operation was primary in 54 limbs and for recurrence in 46 limbs. Thirty-two patients were studied having been re-referred for recurrence while 34 were recalled for review. All were examined clinically and with duplex ultrasonography, and all completed questionnaires (Aberdeen varicose vein questionnaire [AVVQ] and EQ-5D-3L). In order to measure the extent of visible recurrence, a scoring system similar to that in the venous clinical severity score was used but with a range of 0-8. RESULTS There were visible varicosities in 77 of the 100 limbs. Duplex ultrasonography showed that recurrent saphenofemoral incompetence (SFI) was present in 27% of the limbs. This was judged to result from neovascularisation and was the most common source of reflux. AVVQ scores for the 27 limbs with recurrent SFI (median: 34, interquartile range [IQR]: 20-42) were higher than for the 73 with no recurrent SFI (median: 17, IQR: 11-29), which was a significant difference (Mann-Whitney U test, p<0.01). Analysing clinical scores with chi-squared tests indicated fewer visible varicosities in limbs without recurrent SFI than in those with recurrent SFI (p<0.01). CONCLUSIONS Neovascularisation remains poorly understood but it cannot be considered an innocent bystander.

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“…Studies using ultrasound indicated the presence of such vessels in 14% of patients one year after surgery [16]. Neovascularization appears to be responsible for between 8 and 60% of secondary varicose veins [17].…”

Section: Surgical Methodsmentioning

confidence: 99%

Varicose Veins of Lower Extremities, Hemodynamics and Treatment Methods.

Chwała¹,

Szczeklik²,

Szczeklik³

et al. 2015

Adv Clin Exp Med

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Chronic venous insufficiency is one of the most common disorders of the vascular system, affecting approximately 50% of adults. If left untreated it can lead to a number of complications, including venous ulceration and venous thrombosis. This review paper outlines the epidemiology and ethiopathogenesis of the disease with regard to hemodynamics and microcirculation disturbances. It describes the medical treatment as well as the traditional surgical approach to varicose veins (with several modifications of this technique), and its limitations and contraindications. Furthermore, it discusses a number of new, minimally invasive treatment methods, namely thermal in form (radiofrequency ablation, endovenous laser ablation, steam ablation) and nonthermal (sclerotherapy, echosclerotherapy, Clarivein, Sapheon). For each method, there is a brief historical overview, a description of its mechanism of action, and its indications and limitations. The results of comparative studies on individual treatment methods as well as meta-analyses on this topic are briefly discussed. This paper highlights the progressive trend towards minimally invasive methods and attempts to predict the further development (Adv Clin Exp Med 2015, 24, 1, 5-14).

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Neovascularization: An “innocent bystander” in recurrent varicose veins

Cited by 57 publications

References 30 publications

Late follow-up of a randomized trial of routine duplex imaging before varicose vein surgery

Late follow-up of a randomized trial of routine duplex imaging before varicose vein surgery

Neovascularisation is not an Innocent Bystander in Recurrence after Great Saphenous Vein Surgery

Varicose Veins of Lower Extremities, Hemodynamics and Treatment Methods.

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