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Preliminary report of a new approach to sparing the greater saphenous vein for grafting: valvuloplasty combined with axial transposition of a competent tributary vein.
J Endovasc Ther. 2001 Apr; 8(2):188-96.JE

Abstract

PURPOSE

To compare a new vessel-sparing technique combining valvuloplasty with axial transposition of a competent tributary vein versus single valvuloplasty for the treatment of greater saphenous vein (GSV) incompetence.

METHODS

In 55 patients with GSV incompetence, 29 of 57 limbs were treated by angioscopic valvuloplasty of the subterminal valve alone, whereas the remaining 28 limbs underwent angioscopic valvuloplasty combined with axial transposition of a competent tributary vein identified preoperatively by duplex scanning. After angioscopic valvuloplasty in the latter group, the competent tributary vein was exposed and cut 1.5 cm distal to its insertion point on the GSV. The transected vein was anastomosed end to side to the GSV, which was ligated between the tributary insertion site and the anastomosis. Changes in venous hemodynamics, including venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF), were analyzed by use of air plethysmography.

RESULTS

In the 1-year follow-up, no venous thrombosis was detected in either group. In the valvuloplasty-only group, 22 (75.9%) limbs exhibited reflux in the proximal GSV; recurrent varicose veins were detected in 5 (17.2%) limbs. In contrast, only 2 (7.1%) limbs showed reflux in the valvuloplasty + transposition group. There were no significant differences in EF and RVF between the groups before or after the operation, although a significant difference was seen in VFI at 1 year (p = 0.005, Wilcoxon rank sum test).

CONCLUSIONS

Valvuloplasty combined with tributary vein transposition gives a better result than valvuloplasty alone at 1 year. This new treatment option may be useful for both reducing the rate of varicose veins and sparing the GSV for grafting.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Japan. yamaki@prs.twmu.ac.jpNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11357981

Citation

Yamaki, T, et al. "Preliminary Report of a New Approach to Sparing the Greater Saphenous Vein for Grafting: Valvuloplasty Combined With Axial Transposition of a Competent Tributary Vein." Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists, vol. 8, no. 2, 2001, pp. 188-96.
Yamaki T, Nozaki M, Sasaki K. Preliminary report of a new approach to sparing the greater saphenous vein for grafting: valvuloplasty combined with axial transposition of a competent tributary vein. J Endovasc Ther. 2001;8(2):188-96.
Yamaki, T., Nozaki, M., & Sasaki, K. (2001). Preliminary report of a new approach to sparing the greater saphenous vein for grafting: valvuloplasty combined with axial transposition of a competent tributary vein. Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists, 8(2), 188-96.
Yamaki T, Nozaki M, Sasaki K. Preliminary Report of a New Approach to Sparing the Greater Saphenous Vein for Grafting: Valvuloplasty Combined With Axial Transposition of a Competent Tributary Vein. J Endovasc Ther. 2001;8(2):188-96. PubMed PMID: 11357981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preliminary report of a new approach to sparing the greater saphenous vein for grafting: valvuloplasty combined with axial transposition of a competent tributary vein. AU - Yamaki,T, AU - Nozaki,M, AU - Sasaki,K, PY - 2001/5/19/pubmed PY - 2001/10/26/medline PY - 2001/5/19/entrez SP - 188 EP - 96 JF - Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists JO - J Endovasc Ther VL - 8 IS - 2 N2 - PURPOSE: To compare a new vessel-sparing technique combining valvuloplasty with axial transposition of a competent tributary vein versus single valvuloplasty for the treatment of greater saphenous vein (GSV) incompetence. METHODS: In 55 patients with GSV incompetence, 29 of 57 limbs were treated by angioscopic valvuloplasty of the subterminal valve alone, whereas the remaining 28 limbs underwent angioscopic valvuloplasty combined with axial transposition of a competent tributary vein identified preoperatively by duplex scanning. After angioscopic valvuloplasty in the latter group, the competent tributary vein was exposed and cut 1.5 cm distal to its insertion point on the GSV. The transected vein was anastomosed end to side to the GSV, which was ligated between the tributary insertion site and the anastomosis. Changes in venous hemodynamics, including venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF), were analyzed by use of air plethysmography. RESULTS: In the 1-year follow-up, no venous thrombosis was detected in either group. In the valvuloplasty-only group, 22 (75.9%) limbs exhibited reflux in the proximal GSV; recurrent varicose veins were detected in 5 (17.2%) limbs. In contrast, only 2 (7.1%) limbs showed reflux in the valvuloplasty + transposition group. There were no significant differences in EF and RVF between the groups before or after the operation, although a significant difference was seen in VFI at 1 year (p = 0.005, Wilcoxon rank sum test). CONCLUSIONS: Valvuloplasty combined with tributary vein transposition gives a better result than valvuloplasty alone at 1 year. This new treatment option may be useful for both reducing the rate of varicose veins and sparing the GSV for grafting. SN - 1526-6028 UR - https://www.unboundmedicine.com/medline/citation/11357981/Preliminary_report_of_a_new_approach_to_sparing_the_greater_saphenous_vein_for_grafting:_valvuloplasty_combined_with_axial_transposition_of_a_competent_tributary_vein_ L2 - https://journals.sagepub.com/doi/10.1177/152660280100800215?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -