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Femoral venous reflux abolished by greater saphenous vein stripping.
Ann Vasc Surg. 1994 Nov; 8(6):566-70.AV

Abstract

Preoperative venous duplex scanning has revealed unexpected deep venous incompetence in patients with apparently only varicose veins. Acting on the hypothesis that the deep vein reflux was secondary to deep vein dilation caused by reflux volume, the following was done. Between July 1990 and April 1993, 29 limbs in 21 patients (16 females) were examined by color-flow duplex imaging to determine valve closure by the method of van Bemmelen. Instrumentation included high-resolution ATL-9 venous interrogation using a pneumatic cuff deflation stimulus of reflux in the standing, nonweight-bearing limb. All limbs showed greater saphenous vein reflux. Twenty-nine showed superficial femoral vein reflux and of these three showed popliteal vein reflux. Duplex testing was performed by a certified vascular technologist whose interpretation was blinded as to the results of clinical examination and grading of the severity of venous insufficiency. Surgery was performed on an outpatient basis under general anesthesia using groin-to-knee removal of the greater saphenous vein by the vein inversion technique of Van Der Strict. Stab avulsion of varicose tributary veins was accomplished during the same period of anesthesia. In 27 of 29 limbs with preoperative femoral reflux, that reflux was abolished by greater saphenous stripping. In patients with popliteal reflux both femoral and popliteal reflux was abolished. Improvement of deep venous hemodynamics by ablation of superficial reflux supports the reflux circuit theory of venous overload. Furthermore, preoperative evaluation of venous hemodynamics by duplex scanning appears to provide useful pre- and postoperative information regarding venous insufficiency in individual patients.

Authors+Show Affiliations

Scripps Memorial Hospital, La Jolla, Calif.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7865395

Citation

Walsh, J C., et al. "Femoral Venous Reflux Abolished By Greater Saphenous Vein Stripping." Annals of Vascular Surgery, vol. 8, no. 6, 1994, pp. 566-70.
Walsh JC, Bergan JJ, Beeman S, et al. Femoral venous reflux abolished by greater saphenous vein stripping. Ann Vasc Surg. 1994;8(6):566-70.
Walsh, J. C., Bergan, J. J., Beeman, S., & Comer, T. P. (1994). Femoral venous reflux abolished by greater saphenous vein stripping. Annals of Vascular Surgery, 8(6), 566-70.
Walsh JC, et al. Femoral Venous Reflux Abolished By Greater Saphenous Vein Stripping. Ann Vasc Surg. 1994;8(6):566-70. PubMed PMID: 7865395.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Femoral venous reflux abolished by greater saphenous vein stripping. AU - Walsh,J C, AU - Bergan,J J, AU - Beeman,S, AU - Comer,T P, PY - 1994/11/1/pubmed PY - 1994/11/1/medline PY - 1994/11/1/entrez SP - 566 EP - 70 JF - Annals of vascular surgery JO - Ann Vasc Surg VL - 8 IS - 6 N2 - Preoperative venous duplex scanning has revealed unexpected deep venous incompetence in patients with apparently only varicose veins. Acting on the hypothesis that the deep vein reflux was secondary to deep vein dilation caused by reflux volume, the following was done. Between July 1990 and April 1993, 29 limbs in 21 patients (16 females) were examined by color-flow duplex imaging to determine valve closure by the method of van Bemmelen. Instrumentation included high-resolution ATL-9 venous interrogation using a pneumatic cuff deflation stimulus of reflux in the standing, nonweight-bearing limb. All limbs showed greater saphenous vein reflux. Twenty-nine showed superficial femoral vein reflux and of these three showed popliteal vein reflux. Duplex testing was performed by a certified vascular technologist whose interpretation was blinded as to the results of clinical examination and grading of the severity of venous insufficiency. Surgery was performed on an outpatient basis under general anesthesia using groin-to-knee removal of the greater saphenous vein by the vein inversion technique of Van Der Strict. Stab avulsion of varicose tributary veins was accomplished during the same period of anesthesia. In 27 of 29 limbs with preoperative femoral reflux, that reflux was abolished by greater saphenous stripping. In patients with popliteal reflux both femoral and popliteal reflux was abolished. Improvement of deep venous hemodynamics by ablation of superficial reflux supports the reflux circuit theory of venous overload. Furthermore, preoperative evaluation of venous hemodynamics by duplex scanning appears to provide useful pre- and postoperative information regarding venous insufficiency in individual patients. SN - 0890-5096 UR - https://www.unboundmedicine.com/medline/citation/7865395/Femoral_venous_reflux_abolished_by_greater_saphenous_vein_stripping_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(06)60393-2 DB - PRIME DP - Unbound Medicine ER -