Tags

Type your tag names separated by a space and hit enter

Persistent reflux below the knee after stripping of the great saphenous vein.
J Vasc Surg. 2009 Oct; 50(4):831-4.JV

Abstract

OBJECTIVES

This prospective study investigated persistent reflux of the below knee great saphenous knee (GSV) 2 years after stripping the above knee GSV and the effect on reflux of postoperative incompetent perforating veins (IPVs).

METHODS

Included were 59 consecutive ambulatory patients in a community hospital with untreated primary varicose veins and reflux of the saphenofemoral junction and at least the GSV in the upper leg. Patients underwent a preoperative clinical examination and color flow duplex ultrasound imaging. Postoperative evaluations were at 6 months and 2 years, and 67 limbs were re-evaluable. This analysis was adjusted for age, CEAP, follow-up period, and preoperative reflux using a multivariate logistic regression model. The difference in diameter of the GSV below the knee before and after surgery was measured and tested with the paired t test.

RESULTS

Clearly visible varicose veins in the GSV below the knee were seen in 49 limbs (73%) before surgery and after surgery in 11 limbs (16%) at 6 months and in 15 limbs (22%) at 2 years. Reflux in the below knee main stem increased from 81% before surgery to 84% at 6 months and 91% at 2 years after surgery. Reflux in the posterior calf tributary of the GSV decreased from 67% before surgery to 64% at 6 months and 59% at 2 years after surgery. The mean diameter of the below knee GSV main stem decreased from 4.7 mm before surgery to 3.3 mm 6 months after surgery (P < .001), but increased to 3.6 mm 2 years after surgery (P < .05). The mean diameter of the posterior calf tributary of the GSV decreased from 3.5 mm before surgery to 2.7 mm at 6 months (P < .001), but increased to 2.9 mm at 2 years (P < .05). Univariate and multivariate logistic regression shows no association between reflux in one of the GSV below knee branches and postoperative IPVs.

CONCLUSION

Many patients (91%) that undergo a short stripping procedure will have a persistent reflux of the remnant below knee GSV tributaries postoperatively. This incompetence of the distal GSV is independent from the proximal GSV as well from insufficient perforating veins. There seems to be a tendency to worsening of the clinical signs and symptoms between 6 months and 2 years after surgery, and this goes along with an increase of reflux and diameters of the GSV below knee remnants.

Authors+Show Affiliations

Department of Dermatology, Laurentius Hospital, Roermond, The Netherlands. P.vanNeer@lzr.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19595549

Citation

van Neer, Pierre, et al. "Persistent Reflux Below the Knee After Stripping of the Great Saphenous Vein." Journal of Vascular Surgery, vol. 50, no. 4, 2009, pp. 831-4.
van Neer P, Kessels FG, Estourgie RJ, et al. Persistent reflux below the knee after stripping of the great saphenous vein. J Vasc Surg. 2009;50(4):831-4.
van Neer, P., Kessels, F. G., Estourgie, R. J., de Haan, E. F., Neumann, M. A., & Veraart, J. C. (2009). Persistent reflux below the knee after stripping of the great saphenous vein. Journal of Vascular Surgery, 50(4), 831-4. https://doi.org/10.1016/j.jvs.2009.05.021
van Neer P, et al. Persistent Reflux Below the Knee After Stripping of the Great Saphenous Vein. J Vasc Surg. 2009;50(4):831-4. PubMed PMID: 19595549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent reflux below the knee after stripping of the great saphenous vein. AU - van Neer,Pierre, AU - Kessels,Fons G, AU - Estourgie,Rene J, AU - de Haan,Ed F, AU - Neumann,Martino A, AU - Veraart,Joep C, Y1 - 2009/07/12/ PY - 2009/01/23/received PY - 2009/05/12/revised PY - 2009/05/12/accepted PY - 2009/7/15/entrez PY - 2009/7/15/pubmed PY - 2009/10/16/medline SP - 831 EP - 4 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 50 IS - 4 N2 - OBJECTIVES: This prospective study investigated persistent reflux of the below knee great saphenous knee (GSV) 2 years after stripping the above knee GSV and the effect on reflux of postoperative incompetent perforating veins (IPVs). METHODS: Included were 59 consecutive ambulatory patients in a community hospital with untreated primary varicose veins and reflux of the saphenofemoral junction and at least the GSV in the upper leg. Patients underwent a preoperative clinical examination and color flow duplex ultrasound imaging. Postoperative evaluations were at 6 months and 2 years, and 67 limbs were re-evaluable. This analysis was adjusted for age, CEAP, follow-up period, and preoperative reflux using a multivariate logistic regression model. The difference in diameter of the GSV below the knee before and after surgery was measured and tested with the paired t test. RESULTS: Clearly visible varicose veins in the GSV below the knee were seen in 49 limbs (73%) before surgery and after surgery in 11 limbs (16%) at 6 months and in 15 limbs (22%) at 2 years. Reflux in the below knee main stem increased from 81% before surgery to 84% at 6 months and 91% at 2 years after surgery. Reflux in the posterior calf tributary of the GSV decreased from 67% before surgery to 64% at 6 months and 59% at 2 years after surgery. The mean diameter of the below knee GSV main stem decreased from 4.7 mm before surgery to 3.3 mm 6 months after surgery (P < .001), but increased to 3.6 mm 2 years after surgery (P < .05). The mean diameter of the posterior calf tributary of the GSV decreased from 3.5 mm before surgery to 2.7 mm at 6 months (P < .001), but increased to 2.9 mm at 2 years (P < .05). Univariate and multivariate logistic regression shows no association between reflux in one of the GSV below knee branches and postoperative IPVs. CONCLUSION: Many patients (91%) that undergo a short stripping procedure will have a persistent reflux of the remnant below knee GSV tributaries postoperatively. This incompetence of the distal GSV is independent from the proximal GSV as well from insufficient perforating veins. There seems to be a tendency to worsening of the clinical signs and symptoms between 6 months and 2 years after surgery, and this goes along with an increase of reflux and diameters of the GSV below knee remnants. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/19595549/Persistent_reflux_below_the_knee_after_stripping_of_the_great_saphenous_vein_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(09)01033-7 DB - PRIME DP - Unbound Medicine ER -