Preoperative localisation of the saphenopopliteal junction with duplex scanning

Engel, Alexander; Davies, Gareth Alban; Keeman, J. N.

doi:10.1016/s0950-821x(05)80336-6

Cited by 38 publications

(31 citation statements)

References 7 publications

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“…Many surgeons have therefore advocated the use of duplex scanning to mark the position of the SPJ prior to surgery for small saphenous incompetence. 27 Alternatively, the position of the SPJ can be measured from the knee crease at the time of the original duplex scan and this measurement used to site the skin incision appropriately.…”

Section: Dissection Of the Spjmentioning

confidence: 99%

Standard varicose vein surgery

Perkins

2009

Phlebology

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This article examines the practice of standard varicose vein surgery including sapheno-femoral and sapheno-popliteal ligation, perforator surgery and surgery for recurrent varicose veins. The technique of exposure of the sapheno-femoral junction and the sapheno-popliteal junction is outlined and advice given on avoidance of complications for both. The evidence regarding methods of closure over the ligated sapheno-femoral junction is examined as is the requirement for stripping and the use of different types of stripper. The requirement to strip the small saphenous vein and the extent of dissection necessary in the popliteal fossa is also examined. Complications of standard varicose vein surgery are outlined. The frequency of wound infection, nerve injury, vascular injury and venous thromboembolism are listed and strategies to avoid these complications are examined.

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Section: Dissection Of the Spjmentioning

confidence: 99%

Standard varicose vein surgery

Perkins

2009

Phlebology

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“…No estudo realizado por Engel et al, utilizando o eco-Doppler colorido no pré-operatório de cirurgia de varizes, a junção safeno-poplítea localizava-se, em média, 3,4 cm acima da prega poplítea, estando entre 2 e 6 cm em 81,5% dos casos. A acurácia do método comparada aos achados intra-operatórios para a localização da junção foi de 93% 9 . Alguns autores descreveram que, em 8% dos casos, a veia safena parva tem sua desembocadura até 3 polegadas abaixo do joelho 40 .…”

Section: Discussionunclassified

“…O eco-Doppler colorido permite a detecção de refluxo venoso na junção safeno-poplítea e na veia safena parva 8 , locais freqüentes de recidiva e de variações anatômicas, que podem dificultar o tratamento e provocar falha terapêutica 9 .…”

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Prevalência do refluxo na veia safena parva em varizes primárias não complicadas dos membros inferiores pelo eco-Doppler colorido

Secchi

Miyamotto²,

França³

et al. 2006

J. vasc. bras.

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Objective: To determine the prevalence of small saphenous vein reflux (SSVR) in patients with uncomplicated varicose veins, using color-flow Doppler ultrasonography.Method: Over an 18-month period, a total of 1,953 patients underwent color-flow Doppler ultrasonography for evaluation of venous disease. Out of the total, 1,631 patients with primary uncomplicated varicose veins were selected for this study: 1,383 (84.79%) patients were female and 248 (15.21%) were male. Mean age was 42.9 (± 0.48) years, ranging from 13 to 85 years. Of the 1,631 patients, 1,323 underwent bilateral examination and 308 unilateral examination, for a total of 2,954 lower limbs with primary uncomplicated varicose veins studied. The number of right lower limbs studied was 1,461 and the number of left lower limbs was 1,493. All exams were carried out using the same protocol.Result: Out of the total number of 2,954 limbs, SSVR was detected 372 (12.59%) limbs. Prevalence of SSVR in males was 14.08% and in females was 12.35%. SSVR was detected in the right lower limb in 12.05% and in left lower limb in 13.13% of the cases. SSVR was significantly more common in patients older than 60 years.Conclusion: SSVR is relatively common and its presence should always be investigated in patients with primary lower limb varicose veins. Resultado: Dos 2.954 membros inferiores avaliados, 372 (12,59%) apresentaram refluxo em veia safena parva. A prevalência nos homens foi de 14,08% e, nas mulheres, de 12,35%. O refluxo da safena parva foi maior no membro inferior esquerdo (13.13%) do que no direito (12,05%). A prevalência do refluxo foi significativamente maior nos pacientes acima de 60 anos.Conclusão: O refluxo da veia safena parva é relativamente comum, e sua pesquisa deve ser sempre realizada em pacientes com varizes primárias de membros inferiores.

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“…Die 56 Kniekehlenrezidiveingriffe im selben Zeitraum waren bei 296 Primäreingriffen an der V. saphena parva im Verhältnis deutlich höher als jene in der Leiste (Tabelle 2).Die Refluxlokalisationsdiagnostik erfolgte sowohl bei den Primäreingriffen als auch bei den Rezidivoperationen mittels farbcodierter Duplexsonographie (FKDS) [1,4]. Varizenoperationen bei suffizienter Krosse im V.-saphena-magna-oder V.-saphena-parva-Bereich wurden nicht berücksichtigt.…”

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“…Die Refluxlokalisationsdiagnostik erfolgte sowohl bei den Primäreingriffen als auch bei den Rezidivoperationen mittels farbcodierter Duplexsonographie (FKDS) [1,4]. Die Ultraschalluntersuchung erfolgt am Abend vor dem Eingriff, wird vom jeweiligen Operateur durchgeführt und dauert im Schnitt bis zu 30 min.…”

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Die Rezidivvarikosis in der Kniekehle

Nicoló¹,

Schullian²

1998

Gefässchirurgie

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Zwischen Januar 1990 und Dezember 1996 wurden an unserer Klinik 2086 Patienten mit V.-saphena-magna-oder V.-saphenaparva-Varikosis an der jeweiligen Krosse operiert. Varizenoperationen bei suffizienter Krosse im V.-saphena-magna-oder V.-saphena-parva-Bereich wurden nicht berücksichtigt. In diesem Zeitraum führten wir 1864 Primäreingriffe in der Leiste durch und 130 Leistenrezidiveingriffe (Tabelle 1), letztere nicht bezogen auf die Primäreingriffe. Die 56 Kniekehlenrezidiveingriffe im selben Zeitraum waren bei 296 Primäreingriffen an der V. saphena parva im Verhältnis deutlich höher als jene in der Leiste (Tabelle 2).Die Refluxlokalisationsdiagnostik erfolgte sowohl bei den Primäreingriffen als auch bei den Rezidivoperationen mittels farbcodierter Duplexsonographie (FKDS) [1,4]. Die Ultraschalluntersuchung erfolgt am Abend vor dem Eingriff, wird vom jeweiligen Operateur durchgeführt und dauert im Schnitt bis zu 30 min.Ziel unseres Vorgehens war die hohe Rate von Zweiteingriffen in der Kniekehle, wie sie auch von anderen Autoren beschrieben wird [2,5,6,9,12,16,18], zu senken. Seit 1992 versuchen wir sowohl bei Primär-wie auch bei den Rezidiveingriffen in der Fossa poplitea die korrekte Krossektomie durchzuführen, d. h. die Vena poplitea muß sichtbar sein und die V. saphena parva sollte am Niveau abgetragen werden. Wir bevorzugen die Lokalanästhesie [10], führen jedoch den Eingriff auch in Lumbal-oder in Ausnahmefällen in Allgemeinanästhesie durch. Bei den beiden letzteren Narkoseverfahren Gefässchirurgie (1998) 3: 34-36 © Springer-Verlag 1998 ORIGINALARBEIT

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Preoperative localisation of the saphenopopliteal junction with duplex scanning

Cited by 38 publications

References 7 publications

Standard varicose vein surgery

Standard varicose vein surgery

Prevalência do refluxo na veia safena parva em varizes primárias não complicadas dos membros inferiores pelo eco-Doppler colorido

Die Rezidivvarikosis in der Kniekehle

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