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Recurrent varicose veins: sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping.
Vasa. 2006 Feb; 35(1):21-6.VASA

Abstract

BACKGROUND

The objective of this study was to assess the frequency of varicose recurrence 14 years after flush ligation of the saphenofemoral (SFJ) or saphenopopliteal (SPJ) junction with additional stripping of the incompetent saphenous vein.

PATIENTS AND METHODS

Our study group comprised 245 extremities of 210 patients operated upon in 1990 for either great saphenous vein (GSV) or small saphenous vein (SSV) incompetence. Limbs were assessed with Duplex ultrasound by a practitioner other than the original surgeon and relevant patient data was recorded.

RESULTS

In 68.5% of re-examined limbs Duplex imaging provided no evidence for recurrent varicose veins at the former SFJ or SPJ. This included 15 legs (= 6.1%) where reflux immediately proximal to the junction but originating from adjacent veins (i.e. pudendal vein, epigastrical vein) was detected. In 31.5%, reflux from the operated SFJ or SPJ (junctional recurrence) was detected but only a minor percentage of legs (6.9%) had actually developed a clinically relevant recurrent varicosity (> 3 mm in diameter) branching out from the former junction and requiring treatment. Patients with a BMI < 30 were less likely to suffer recurrent varicose veins (no recurrence in 72.7%) than patients with a BMI > or = 30 (no recurrence in 54.5%).

CONCLUSIONS

14 years after flush ligation of the SFJ or SPJ with stripping of the incompetent saphenous vein, junctional recurrences were found in less than one-third of re-examined extremities. In the absence of surgical errors, we must assume neovascularisation as cause for these recurrences. Duplex US determined a clinically relevant recurrence (> 3 mm in diameter) in only 7% of limbs. Post-operative varices seem to develop less often after SPJ surgery than after SFJ surgery and according to our data, obesity (BMI > or = 30) constitutes a significant risk factor.

Authors+Show Affiliations

Phlebologische Gemeinschaftspraxis Hartmann & Partner, Freiburg, Germany. kahartmann@web.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16535965

Citation

Hartmann, K, et al. "Recurrent Varicose Veins: Sonography-based Re-examination of 210 Patients 14 Years After Ligation and Saphenous Vein Stripping." VASA. Zeitschrift Fur Gefasskrankheiten, vol. 35, no. 1, 2006, pp. 21-6.
Hartmann K, Klode J, Pfister R, et al. Recurrent varicose veins: sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping. Vasa. 2006;35(1):21-6.
Hartmann, K., Klode, J., Pfister, R., Toussaint, M., Weingart, I., Waldermann, F., & Hartmann, M. (2006). Recurrent varicose veins: sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping. VASA. Zeitschrift Fur Gefasskrankheiten, 35(1), 21-6.
Hartmann K, et al. Recurrent Varicose Veins: Sonography-based Re-examination of 210 Patients 14 Years After Ligation and Saphenous Vein Stripping. Vasa. 2006;35(1):21-6. PubMed PMID: 16535965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrent varicose veins: sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping. AU - Hartmann,K, AU - Klode,J, AU - Pfister,R, AU - Toussaint,M, AU - Weingart,I, AU - Waldermann,F, AU - Hartmann,M, PY - 2006/3/16/pubmed PY - 2006/4/13/medline PY - 2006/3/16/entrez SP - 21 EP - 6 JF - VASA. Zeitschrift fur Gefasskrankheiten JO - Vasa VL - 35 IS - 1 N2 - BACKGROUND: The objective of this study was to assess the frequency of varicose recurrence 14 years after flush ligation of the saphenofemoral (SFJ) or saphenopopliteal (SPJ) junction with additional stripping of the incompetent saphenous vein. PATIENTS AND METHODS: Our study group comprised 245 extremities of 210 patients operated upon in 1990 for either great saphenous vein (GSV) or small saphenous vein (SSV) incompetence. Limbs were assessed with Duplex ultrasound by a practitioner other than the original surgeon and relevant patient data was recorded. RESULTS: In 68.5% of re-examined limbs Duplex imaging provided no evidence for recurrent varicose veins at the former SFJ or SPJ. This included 15 legs (= 6.1%) where reflux immediately proximal to the junction but originating from adjacent veins (i.e. pudendal vein, epigastrical vein) was detected. In 31.5%, reflux from the operated SFJ or SPJ (junctional recurrence) was detected but only a minor percentage of legs (6.9%) had actually developed a clinically relevant recurrent varicosity (> 3 mm in diameter) branching out from the former junction and requiring treatment. Patients with a BMI < 30 were less likely to suffer recurrent varicose veins (no recurrence in 72.7%) than patients with a BMI > or = 30 (no recurrence in 54.5%). CONCLUSIONS: 14 years after flush ligation of the SFJ or SPJ with stripping of the incompetent saphenous vein, junctional recurrences were found in less than one-third of re-examined extremities. In the absence of surgical errors, we must assume neovascularisation as cause for these recurrences. Duplex US determined a clinically relevant recurrence (> 3 mm in diameter) in only 7% of limbs. Post-operative varices seem to develop less often after SPJ surgery than after SFJ surgery and according to our data, obesity (BMI > or = 30) constitutes a significant risk factor. SN - 0301-1526 UR - https://www.unboundmedicine.com/medline/citation/16535965/Recurrent_varicose_veins:_sonography_based_re_examination_of_210_patients_14_years_after_ligation_and_saphenous_vein_stripping_ L2 - https://econtent.hogrefe.com/doi/10.1024/0301-1526.35.1.21?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -