A clinical study of varicose veins and their management in patients attending the surgical department of a tertiary hospital

Leg ulcer treatment

Presidential address: Venous disorders—Reflections of the past three decades

Chronic Venous Insufficiency

Background:Varicose veins are a subset of Chronic Venous disorders, including spider, reticular, varicose, and leg oedema. In our country, varicose veins are common surgical problems most commonly seen in low socio-economic groups and associated with certain occupation(s). Varicose veins have been known to affect the quality of life (QoL) leading to changes in occupation. Surgical treatment methods such as Saphenofemoral Junction (SFJ) Ligation and Great Saphenous Vein (GSV) stripping with spinal or general anaesthesia, Radio Frequency Ablation (RFA), Endovascular Laser Ablation (EVLA) and GLUE Technique within the operating room are considered in patients who remain refractory to conservative management and continue being symptomatic.Aim & Objectives:The study aimed to compare the outcome and associated post-operative complications, including Deep Venous Thrombosis, Pulmonary Embolism or Paresthesia, and Ecchymosis, with various modalities in the management of varicose veins.Material and Methods:The study was performed at a tertiary care centre which included 200 patients over a period of one year and was evaluated in the basis of VCSS & VDS scores.Results:We observed that all treatment protocols demonstrated results which improved the general physical condition of patients with the least number of complications. Treatment for varicose veins encompasses open surgeries and Endovenous techniques (EVLA and RFA), which show comparative results in clinical improvement, complications and postoperative hospital stay. Both VCSS and VDS are sensitive tools for measuring clinical outcomes of treatments of venous disease. However, the choice of appropriate tool is dependent upon the type of treatment, the Surgeon ‘s personal experience, availability of resources, durations of hospital admission and cost of treatment.

Endovascular Ablation Therapies for Varicose Veins in Elderly Patients

Chapter 1 - Epidemiology, Aetiology and Symptomatology.

Chapter 2 - Diagnostics.

Chapter 8 - Life style.

Chapter 6 - Oral medication.

Chapter 3 - Compression therapy.

The definition of the venous ulcer

Recommended reporting standards for endovenous ablation for the treatment of venous insufficiency: Joint Statement of the American Venous Forum and the Society of Interventional Radiology

The aim of the study was a comparative histomorphological evaluation of the results of laser-technological treatment of patients with varicose veins of the lower extremities. The study planned to examine the effectiveness of the combined use of endovascular laser ablation (EVLA), Venocoryl ointment and low-intensity laser beams in the treatment of trophic wounds caused by varicose veins of the lower extremities, as well as morphological changes in the skin and subcutaneous tissue in the ulcer area. Patients were randomized into 3 groups of 25 patients each: Group I – EVLA and mini-phlebectomy were performed together. Group II – EVLA, Venocoryl ointment and low-intensity laser beams were used in complex treatment. Group III – EVLA, miniphlebectomy and Venocoryl ointment were prescribed together for treatment. During the experiment, the morphological changes recorded in different groups were mostly identical and their dynamics were parallel. During this period, many morphological parameters representing tissue damage disappeared, especially in biopsies taken on the 7th day. Based on the above indicators, it can be said that in dynamic observation, the combined application of EVLA, Venocoryl ointment and low-intensity laser beams in the main group has almost the same effect as other treatment methods, but the faster reduction of thrombi in the microcirculation in the main group allows us to say that this organization of treatment provides earlier restoration of microcirculatory circulation. Therefore, it can be successfully applied in the treatment of varicose veins as an alternative treatment plan.

The aim of the study was a comparative histomorphological evaluation of the results of laser-technological treatment of patients with varicose veins of the lower extremities. The study planned to examine the effectiveness of the combined use of endovascular laser ablation (EVLA), Venocoryl ointment and low-intensity laser beams in the treatment of trophic wounds caused by varicose veins of the lower extremities, as well as morphological changes in the skin and subcutaneous tissue in the ulcer area. Patients were randomized into 3 groups of 25 patients each: Group I – EVLA and mini-phlebectomy were performed together. Group II – EVLA, Venocoryl ointment and low-intensity laser beams were used in complex treatment. Group III – EVLA, miniphlebectomy and Venocoryl ointment were prescribed together for treatment. During the experiment, the morphological changes recorded in different groups were mostly identical and their dynamics were parallel. During this period, many morphological parameters representing tissue damage disappeared, especially in biopsies taken on the 7th day. Based on the above indicators, it can be said that in dynamic observation, the combined application of EVLA, Venocoryl ointment and low-intensity laser beams in the main group has almost the same effect as other treatment methods, but the faster reduction of thrombi in the microcirculation in the main group allows us to say that this organization of treatment provides earlier restoration of microcirculatory circulation. Therefore, it can be successfully applied in the treatment of varicose veins as an alternative treatment plan.

Background: Varicose veins of lower limb are multiple elongated dilated and tortuous veins. It is a progressive disease that worsens as the day passes. The treatment modalities available are conservative, surgical and endovenous therapies. It is accepted that surgical treatment is required for symptomatic varicose veins, to relieve symptoms and to prevent the long-term sequelae of eczema, lipodermatosclerosis and venous ulceration. Different surgical interventions may be used, but most preferred treatment applied is saphenofemoral flush ligation and ligation of incompetent perforators. Methods: This prospective comparative study was conducted on 60 patients in the department of general surgery, Mamata general hospital from July 2020 to June 2022. 60 patients were allocated into two groups of 30 patients each, who underwent flush ligation of saphenofemoral junction with stripping of long saphenous varicose vein and Trendelenburg surgery alone (flush ligation of sapheno femoral junction) respectively. Results: The hematoma formation in the thigh was seen in 23.33% of patients who underwent venous stripping whereas it was seen only in 3.33% who underwent Trendelenburg procedure alone. These wounds were examined in the postoperative period. Delayed wound healing was observed in 26.66% in patients with venous stripping and it was 10% with Trendelenburg procedure alone. There was no significant difference in postoperative ambulation, hospital stay and pain relief after 2 months. Conclusions: From this study with the observed variables, it is concluded that the Trendelenburg procedure with incompetent perforators ligation without venous stripping appears to be better than Trendelenburg procedure with incompetent perforators ligation with venous stripping.