Varicose Vein Surgery

Ombrellino, Michael; Kabnick, Lowell S.

doi:10.1055/s-2005-921951

Cited by 14 publications

(10 citation statements)

References 23 publications

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“…9 The common presenting symptoms in our study are similar to what mentioned in review article by Ombrellino et al 10 In our study 74.5% of cases had history of occupation requiring prolonged standing. This finding is higher compared to the finding by Tabatabaeifar et al In their study, in 60% of cases of varicose vein requiring surgery, there was history of prolonged standing, walking and heavy lifting.…”

Section: Original Articlesupporting

confidence: 89%

Analysis of Consecutive Open Surgeries for Varicose Vein at Dhulikhel Hospital

Karmacharya

Shakya

Shrestha

2015

Kathmandu Univ. Med. J.

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BackgroundVaricose veins are prominent dilated veins in the lower limb primarily due to disease in the junction between superficial and deep venous system. Operative treatment of such condition significantly improves quality of life and also demonstrably decreases the potential complications. We present with analysis of fifty one consecutive open surgeries for varicose vein at Dhulikhel Hospital. ObjectiveTo analyze consecutive open surgeries for varicose vein in terms of gender, age, presenting complaints, findings and post operative outcomes. MethodAll the cases posted for open surgeries for varicose vein at Dhulikhel Hospital during September 2012 -July 2013 were included. If great saphenous vein in thigh was more than 3 mm, segmental stripping was done. The collected data was analyzed using SPSS version 13.0. ResultThere were 51 cases with 47%male and 53% female. Mean age was 48.9 years. Prominent dilated vein was the most common presenting complaints. Incompetent saphenofemoral junction was present in 68.6% cases. Segmental stripping was done in 51% cases. Mean days of admission was 2.6 days. Mean pain free day was on 3.2 days. In an average, patient were able to walk normally in 4.1 days. Analysis of hospital admission days, ability to walk normally and pain free day attained in between stripping required and stripping not required group showed significant difference with higher values in stripping required group. ConclusionAlthough conventional stripping surgery has long been performed for varicose vein, this is associated with prolonged hospital admission, prolonged time required for ability to walk normally, and prolonged time taken for pain free status. Hence newer modalities of treatment like radiofrequency ablation is warranted in our setup too.

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Section: Original Articlesupporting

confidence: 89%

Analysis of Consecutive Open Surgeries for Varicose Vein at Dhulikhel Hospital

Karmacharya

Shakya

Shrestha

2015

Kathmandu Univ. Med. J.

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“…The available therapeutic options include conservative therapies (phlebotonic drugs, lower limbs elastic compression), ablative surgical or endovenous procedures (sclerotherapy, laser/thermal venous shrinkage) and saphenous sparing hemodynamic surgery [ 3 ]. Although a significant effort has been made on the development and evaluation of techniques that might assist in both diagnosis and treatment of CVI, the etiopathology of this condition still needs to be clarified and CVI remains a disease with a high recurrence rate that will be possibly reduced just whenever deeper comprehension of the pathophysiological mechanisms will be obtained [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Modulation of Circulating Cytokine-Chemokine Profile in Patients Affected by Chronic Venous Insufficiency Undergoing Surgical Hemodynamic Correction

Tisato

Zauli

Gianesini

et al. 2014

Journal of Immunology Research

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The expression of proinflammatory cytokines/chemokines has been reported in in vitro/ex vivo settings of chronic venous insufficiency (CVI), but the identification of circulating mediators that might be associated with altered hemodynamic forces or might represent innovative biomarkers is still missing. In this study, the circulating levels of 31 cytokines/chemokines involved in inflammatory/angiogenic processes were analysed in (i) CVI patients at baseline before surgical hemody namic correction, (ii) healthy subjects, and (iii) CVI patients after surgery. In a subgroup of CVI patients, in whom the baseline levels of cytokines/chemokines were analyzed in paired blood samples obtained from varicose vein and forearm vein, EGF, PDGF, and RANTES were increased at the varicose vein site as compared to the general circulation. Moreover, while at baseline, CVI patients showed increased levels of 14 cytokines/chemokines as compared to healthy subjects, 6 months after surgery, 11 cytokines/chemokines levels were significantly reduced in the treated CVI patients as compared to the CVI patients before surgery. Of note, a patient who exhibited recurrence of the disease 6 months after surgery, showed higher levels of EGF, PDGF, and RANTES compared to nonrecurrent patients, highlighting the potential role of the EGF/PDGF/RANTES triad as sensitive biomarkers in the context of CVI.

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“…A study in Australia showed that the color Doppler ultrasound, when used alone, led to six false positives in 165 limbs whereas the clinical examination had zero. They advocated the use of the clinical examination alone but this would have resulted in a lesser detection rate of 72% [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study

Sureshkumar

Vignesh

Jayaseelan

et al. 2018

Cureus

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BackgroundThe color Doppler, a better investigation to identify the perforators objectively has replaced the clinical examination for the same. However, this has led to a significant number of negative explorations and cosmetic disfigurement.ObjectiveTo compare the efficacy of the clinical tests combined with the color Doppler versus color Doppler alone to identify the perforator incompetence during the surgery for primary varicose veins of the lower limb.MethodsThis was a prospective analytical study, including 61 lower limb varicose vein patients who belonged to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) class four-six, planned for the surgical treatment for perforator incompetence, excluding those requiring additional vascular or nonvascular procedure, recurrent varicose veins and those who had injection sclerotherapy prior to the surgery. The clinical tests, including Trendelenburg’s test, multiple tourniquet tests and, the Fegan’s tests were performed and incompetent perforators were marked on a template as ‘C’ to indicate the clinically positive perforator incompetence. The patients were then examined with the color Doppler ultrasound and the pathological incompetent perforators were marked as ‘D’. The surgical management of the perforator incompetence was done by stab ligation. The incision was made in the color Doppler ‘D’ marked sites as it has been the standard protocol. The number of incompetent perforators identified during the surgical exploration were categorized as ‘D’ positive or ’C’ and ‘D’ positive and were recorded in the specified proforma.ResultsIt was found that the mean number of the perforator incompetence identified by the color Doppler alone was 8.2 whereas during the surgery, only a mean of six perforators was identified, leading to 20 unnecessary explorations per 10 patients (8.2 vs. 6; mean difference 2.229; P <0.001). The mean number of the perforator incompetence identified by the color Doppler combined with the clinical tests was 4.5 and during the surgery, a mean of four perforators was identified (4.5 vs. 4; mean difference 0.377; P <0.001). The color Doppler combined with the clinical examination lead to only four unnecessary explorations per 10 patients.ConclusionA combination of both the clinical tests and the color Doppler ultrasound has a higher accuracy in detecting perforator incompetence and can reduce the number of negative explorations by the rate of 16 unnecessary explorations per 10 patients.

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Varicose Vein Surgery

Cited by 14 publications

References 23 publications

Analysis of Consecutive Open Surgeries for Varicose Vein at Dhulikhel Hospital

Analysis of Consecutive Open Surgeries for Varicose Vein at Dhulikhel Hospital

Modulation of Circulating Cytokine-Chemokine Profile in Patients Affected by Chronic Venous Insufficiency Undergoing Surgical Hemodynamic Correction

Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study

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