Abstract
To evaluate the efficacy of surgical treatment of varicose veins with preservation of the great saphenous vein. We conducted a prospective study of 15 female patients between 25 and 55 years of age with clinical, etiologic, anatomic and pathophysiologic (CEAP) classification 2, 3 and 4. The patients underwent surgical treatment of primary varicose veins with great saphenous vein (GSV) preservation. Doppler ultrasonography exams were carried out in the first and third months postoperatively. The form of clinical severity of venous disease, Venous Clinical Severity Score (VCSS) was completed before and after surgery. We excluded patients with history of deep vein thrombosis, smoking or postoperatively use of elastic stockings or phlebotonics. All patients had improved VCSS (p <0.001) and reduction in the diameter of the great saphenous vein (p <0.001). There was a relationship between VCSS and the GSV caliber, as well as with preoperative CEAP. There was improvement in CEAP class in nine patients when compared with the preoperative period (p <0.001). The varicose vein surgery with preservation of the great saphenous vein had beneficial effects to the GSV itself, with decreasing caliber, and to the symptoms when the vein had maximum caliber of 7.5 mm, correlating directly with the CEAP. The decrease in GSV caliber, even without complete abolition of reflux, leads to clinical improvement by decreasing the reflux volume.
Highlights
Chronic venous insufficiency (CVI) is defined as an abnormality in the functioning of the venous system due to venous hypertension caused by venous reflux, obstruction of venous flow, or by the combination of these two factors[1]
The authors aimed to evaluate the importance of surgical treatment of lower limb varicose veins with preservation of the great saphenous vein in clinical regression of chronic venous disease
We evaluated a total of 22 lower limbs of 15 female patients with chronic venous insufficiency (CVI), according to the clinical, etiologic, anatomic and pathophysiologic classification
Summary
Chronic venous insufficiency (CVI) is defined as an abnormality in the functioning of the venous system due to venous hypertension caused by venous reflux, obstruction of venous flow, or by the combination of these two factors[1]. The prevalence of chronic venous insufficiency in the population increases with age. Maffei et al.[12] conducted an epidemiological study on venous alterations of the lower limbs in the population of Botucatu / SP and found an estimated prevalence of 35.5% of varicose veins and 1.5% of severe forms of CVI, with active or healed ulcers. 1. Hospital Universitário Pedro Ernesto, Universidade Estadual do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; 2. Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil; 3. The authors aimed to evaluate the importance of surgical treatment of lower limb varicose veins with preservation of the great saphenous vein in clinical regression of chronic venous disease
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