Abstract
Summary Introduction. The anatomical complexity and widely varying distribution of the external saphenous vein (ESV) means that surgical treatment is associated to high rates of relapse and residual varicose veins. Aim. To evaluate the mid-term results of using the CHIVA cure strategy on ESV varicose veins. Patients and methods. Between February 1996 and December 2002 we performed 142 CHIVA interventions to treat ESV. A random sample of 80 interventions was taken and data collected about their factors related to chronic venous insufficiency, pre-operative clinical features (CEAP), primary shunt and the surgical strategy applied. Doppler ultrasound was used to assess competence, patency, flow direction, diameter and neoaortic arch of the ESV in the post-operative period, visible relapses and symptoms. In addition, the relationships between the following parameters were also analysed: Doppler ultrasound recordings, surgical strategy, relapses and symptoms. Results. Competence of the deep vein system (DVS) and ESV patency were found to be > 95% (four ESV thromboses). Haemodynamically favourable situations: 66%. Mean diameter of the ESV: 3.5 cm; neoaortic arch: six patients (7.5%). Clinical features of the post-operative period: 59 asymptomatic patients (73.8%), 16 with a clinical improvement (20%) and five patients with no improvement in their symptoms (6%). Visible relapses: 15 cases, 12 of which were not important enough to require reintervention. There were no cases of DVS thromboses or peripheral neuropathy. There was a statistically significant correlation between the presence of anterograde flow and the absence of relapses and symptoms in the postoperative period, as well as between symptoms and relapses with higher absolute ESV diameters and neoaortic arch. There was a correlation, although statistically non-significant, between relapses and symptoms in the postoperative period and surgical strategy. Conclusion. The best results (i.e. less thromboses and relapses): CHIVA 1 + 2 in the case of ESV. [ANGIOLOGIA 2004; 56: 481-90]
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