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Clinical and hemodynamical findings in legs with previous surgery of the great saphenous vein: role of the small saphenous vein.
J Cardiovasc Surg (Torino). 2007 Aug; 48(4):485-9.JC

Abstract

AIM

To assess the role of small saphenous vein (SSV) reflux in patients with a long history of varicose disease and previous stripping of the great saphenous vein (GSV).

METHODS

Consecutive patients with a history of GSV stripping 5-19 years earlier were enrolled in this prospective clinical study. A total of 101 legs of 75 consecutive patients fulfilled the study criteria: previous stripping of GSV from ankle to groin at least 5 years earlier, no history of thromboembolism and no previous surgery of deep veins or SSV. All patients were studied clinically using standardized classifications: clinical class, clinical disability score (CDS) and venous clinical scoring system (VCSS). Colour flow duplex imaging (CFDI) was used to assess reflux in deep and superficial veins. Details of prior surgery were evaluated.

RESULTS

Overall, SSV reflux was noted in 28 (28%) of the legs, recurrent GSV (rGSV) in the thigh in 41 (41%), reflux in tributaries alone in 28 (28%) and a combination of SSV and rGSV reflux in 4 (3%). Segmental deep reflux was measured in 23 (23%) of the legs; the prevalence of deep reflux was significantly higher in complicated than in uncomplicated legs (12% versus 47%; P<0.05). Deep reflux was more frequently associated with SSV reflux than with rGSV reflux (50% versus 22%; P<0.05). The prevalence of SSV with or without deep reflux increased from 17% to 50% (P<0.05) when uncomplicated (C2-3) and complicated (C4-6) legs were compared. A similar increase was not seen in the legs with rGSV (39% versus 44%; P>0.05). SSV reflux without deep reflux was observed in 25% of the legs with complicated (C4-6) disease, whereas the prevalence of SSV reflux was low (9%) in uncomplicated (C2-3) legs. VCSS was higher in the legs with SSV reflux than in those with rGSV reflux. CDS scores tended to be higher in the SSV reflux group than in the legs with rGSV reflux or tributary reflux alone. After exclusion of deep reflux, the results remained at the same level.

CONCLUSION

Small saphenous vein (SSV) reflux is common in legs with recurrent varicose veins and previous stripping of the GSV. SSV reflux alone is frequent in complicated legs, and SSV reflux is typically associated with segmental deep reflux. Clinical and hemodynamical findings stress the role of SSV reflux in this selected venous population.

Authors+Show Affiliations

Saarinen JP
Department of Surgery, Division of Vascular Surgery, Tampere University Hospital, 33521 Tampere, Finland. jukka.saarinen@pshp.fi
Heikkinen MA
No affiliation info available
Rasku K
No affiliation info available
Salenius JP
No affiliation info available

MeSH

AdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrevalenceProspective StudiesRecurrenceRisk FactorsSaphenous VeinSclerotherapySeverity of Illness IndexVaricose VeinsVenous Insufficiency

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17653009

Citation

Saarinen, J P., et al. "Clinical and Hemodynamical Findings in Legs With Previous Surgery of the Great Saphenous Vein: Role of the Small Saphenous Vein." The Journal of Cardiovascular Surgery, vol. 48, no. 4, 2007, pp. 485-9.
Saarinen JP, Heikkinen MA, Rasku K, et al. Clinical and hemodynamical findings in legs with previous surgery of the great saphenous vein: role of the small saphenous vein. J Cardiovasc Surg (Torino). 2007;48(4):485-9.
Saarinen, J. P., Heikkinen, M. A., Rasku, K., & Salenius, J. P. (2007). Clinical and hemodynamical findings in legs with previous surgery of the great saphenous vein: role of the small saphenous vein. The Journal of Cardiovascular Surgery, 48(4), 485-9.
Saarinen JP, et al. Clinical and Hemodynamical Findings in Legs With Previous Surgery of the Great Saphenous Vein: Role of the Small Saphenous Vein. J Cardiovasc Surg (Torino). 2007;48(4):485-9. PubMed PMID: 17653009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and hemodynamical findings in legs with previous surgery of the great saphenous vein: role of the small saphenous vein. AU - Saarinen,J P, AU - Heikkinen,M A, AU - Rasku,K, AU - Salenius,J P, PY - 2007/7/27/pubmed PY - 2007/12/20/medline PY - 2007/7/27/entrez SP - 485 EP - 9 JF - The Journal of cardiovascular surgery JO - J Cardiovasc Surg (Torino) VL - 48 IS - 4 N2 - AIM: To assess the role of small saphenous vein (SSV) reflux in patients with a long history of varicose disease and previous stripping of the great saphenous vein (GSV). METHODS: Consecutive patients with a history of GSV stripping 5-19 years earlier were enrolled in this prospective clinical study. A total of 101 legs of 75 consecutive patients fulfilled the study criteria: previous stripping of GSV from ankle to groin at least 5 years earlier, no history of thromboembolism and no previous surgery of deep veins or SSV. All patients were studied clinically using standardized classifications: clinical class, clinical disability score (CDS) and venous clinical scoring system (VCSS). Colour flow duplex imaging (CFDI) was used to assess reflux in deep and superficial veins. Details of prior surgery were evaluated. RESULTS: Overall, SSV reflux was noted in 28 (28%) of the legs, recurrent GSV (rGSV) in the thigh in 41 (41%), reflux in tributaries alone in 28 (28%) and a combination of SSV and rGSV reflux in 4 (3%). Segmental deep reflux was measured in 23 (23%) of the legs; the prevalence of deep reflux was significantly higher in complicated than in uncomplicated legs (12% versus 47%; P<0.05). Deep reflux was more frequently associated with SSV reflux than with rGSV reflux (50% versus 22%; P<0.05). The prevalence of SSV with or without deep reflux increased from 17% to 50% (P<0.05) when uncomplicated (C2-3) and complicated (C4-6) legs were compared. A similar increase was not seen in the legs with rGSV (39% versus 44%; P>0.05). SSV reflux without deep reflux was observed in 25% of the legs with complicated (C4-6) disease, whereas the prevalence of SSV reflux was low (9%) in uncomplicated (C2-3) legs. VCSS was higher in the legs with SSV reflux than in those with rGSV reflux. CDS scores tended to be higher in the SSV reflux group than in the legs with rGSV reflux or tributary reflux alone. After exclusion of deep reflux, the results remained at the same level. CONCLUSION: Small saphenous vein (SSV) reflux is common in legs with recurrent varicose veins and previous stripping of the GSV. SSV reflux alone is frequent in complicated legs, and SSV reflux is typically associated with segmental deep reflux. Clinical and hemodynamical findings stress the role of SSV reflux in this selected venous population. SN - 0021-9509 UR - https://www.unboundmedicine.com/medline/citation/17653009/Clinical_and_hemodynamical_findings_in_legs_with_previous_surgery_of_the_great_saphenous_vein:_role_of_the_small_saphenous_vein_ L2 - https://medlineplus.gov/varicoseveins.html DB - PRIME DP - Unbound Medicine ER -