Varicose Vein Stripping Research Articles

Complications of Endovenous Ablation Vs Surgical Stripping of Varicose Veins

Complications of Endovenous Ablation Vs Surgical Stripping of Varicose Veins

Clinical outcomes of nonthermal ablation, thermal ablation, and surgical stripping for varicose veins

ObjectiveThe purpose of this study was to compare the clinical outcomes of radiofrequency ablation (RFA), cyanoacrylate closure (CAC), mechanochemical ablation (MOCA), and surgical stripping (SS) for incompetent saphenous veins and to determine a suitable treatment modality for a specific clinical situation. MethodsWe retrospectively reviewed the data of patients with varicose veins who underwent RFA, CAC, MOCA, or SS from January 2012 to June 2023. The clinical outcomes, including postoperative complications and the Aberdeen Varicose Vein Questionnaire score, were assessed. ResultsDuring the study period, 2866 patients with varicose veins were treated. Among them, 1670 patients (57.9%) were women. The mean age was 55.3 ± 12.9 years. RFA, CAC, MOCA, and SS were performed in 1984 (68.7%), 732 (25.4%), 78 (2.7%), and 88 (3.0%) patients, respectively. The complete target vein closure rate after RFA, CAC, and MOCA was 94.5%, 98%, and 98%, respectively. The absence of a target vein after SS was 98%. Deep vein thrombosis developed in four patients: one in the RFA group and three in CAC group. Surgical or endovenous procedure-induced thrombosis occurred in 2.3%, 4.8%, 6.4%, and 2.3% of the patients after RFA, CAC, MOCA, and SS, respectively. Phlebitis along the target vein occurred in 0.2% and 3.8% of patients after RFA and MOCA, respectively. A hypersensitivity reaction occurred in 3.7% of patients after CAC. Readmission was required for two patients who had undergone SS. Transient nerve symptoms developed in five (0.3%), zero, one (1.3%), and two (2.3%) patients after RFA, CAC, MOCA, and SS, respectively. After treatment, the Aberdeen Varicose Vein Questionnaire score improved significantly in all groups. ConclusionsThe clinical outcomes with improvement in quality of life were comparable among the different treatment modalities. The proximity of the nerve or skin to the target vein is the most important factor in selecting a suitable treatment modality.

Safety of Ultrasound Guided Endovenous Management of Varicose Veins and How to Avoid Potential Complications

Background Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) have been used to treat superficial venous insufficiency, Ablation of veins has replaced operative saphenectomy as the procedure of choice for the treatment of superficial venous insufficiency. This change has likely taken place due to the minimally invasive nature and acceptable safety of endovenous ablation while remaining as efficacious and durable as saphenous ligation and stripping. Pattern of complications had been changed over the past decade, due to shifting from surgical stripping of varicose veins to endovenous procedures. The incidence of complications vary widely based on the level of operators as ecchymosis incidence post endovenous procedure range from (52-100%), parathesia (0.5 - 41.5%), phlebitis (0.5 – 5.5%), burn (0.46%), DVT (0.27%), and pulmonary embolism in 0.02% of cases. Aim of the Work assessing the incidence of complications during endovenous procedures of varicose veins and possible preventive measures. Assessing incidence of complications during Endovenous laser ablation (EVLA), radiofrequency ablation and injection sclerotherapy. Assessing the preventive measures that could be conducted to decrease the incidence of complications of endovenous surgeries. Patients and Methods Type of study retrospective cohort study study setting the study will be conducted at Ain Shams University Hospitals, interventional radiology department study period 2 years study population patients admitted in interventional radiology department during the past 2 years and scheduled for varicose veins treatment. Results was conducted on 20 patients, 70.0% were males and 30.0% were females with mean age of the study group was 45.35 ± 11.34 years ranged from 28 to 65 years. Most patients with no known medical or surgical history 65.5%, 25.0% were diabetic and 5.0% were hypertensive. Conclusion because most of the side effects are minor, and major complications are rare, EVLA is a safe and minimally invasive procedure with excellent efficacy in the treatment of varicose veins. Because optimizing laser parameters and the EVLA procedure may reduce the incidence and severity of complications associated with EVLA, additional research is warranted.

National trend of the treatment for chronic venous diseases in Korea between 2010 and 2020.

Limited data are available on the nationwide trend of treatments for chronic venous disease (CVD). The aim of the present study was to identify the nationwide trends of CVD treatments in Korea. A serial, cross-sectional study was conducted with the use of time trends to analyze patients with CVD between 2010 and 2020. The trends in the number of patients and procedures were analyzed including sclerotherapy, open surgery, and endovenous thermal ablation (ETA). Health Insurance Review and Assessment Service data were used to analyze the trends. For the statistical analysis, MedCalc Statistical software was used. P < 0.05 was considered statistically significant. A total of 1,867,307 patients with CVD were managed in Korea between 2010 and 2020. The annual number of patients with CVD increased from 143,108 in 2010 to 219,319 in 2020 (risk ratio [RR], 1.53; P < 0.001). The percentage of patients with CVD who had venous ulcer gradually decreased from 3.1% in 2010 to 1.7% in 2020 (RR, 0.86; P < 0.001). The number of conventional surgeries including stripping and local resection of varicose veins decreased from 32,384 in 2010 to 21,792 in 2020 (RR, 0.67; P < 0.001). The number of ETAs performed increased, from 290 in 2011 to 12,126 procedures in 2020 (RR, 41.81; P < 0.001). The total number of patients with CVD increased during the last 11 years. The number of conventional open surgery and sclerotherapy procedures decreased. On the contrary, the number of ETAs significantly increased in Korea.

Strategies and challenges in treatment of varicose veins and venous insufficiency.

Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences. In the recent decade, the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques. The literature was systematically searched on Medline without language restrictions. All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed. Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) both are same safe and effective in terms of occlusion rate, and time to return to normal activity. In comparison with RFA or EVLT, Cure conservatrice et Hemodynamique de l'Insufficience Veineuse en Ambulatoire (CHIVA) may cause more bruising and make little or no difference to rates of limb infection, superficial vein thrombosis, nerve injury, or hematoma. In terms of recurrence of varicose veins, there is little or no difference between CHIVA and stripping, RFA, or EVLT. Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy (FS) group (51%) during 1 year of follow-up. The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy. Although the mechanochemical endovenous ablation (MOCA) is a non-thermal, non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage, the overall success rate of MOCA is lower than those of other procedures such as EVLA, RFA, or high ligation and stripping. EVLA is the most cost-effective therapeutic option, with RFA being a close second for the treatment of patients with varicose veins. Endovenous thermal ablation (EVLA or RFA) is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins. Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures. MOCA and cyanoacrylate embolization appear promising, but evidence of their effectiveness is required.

The Effect of Body Mass Index on Outcome Following Ambulatory High Ligation and Stripping for Lower Varicose Veins: A Prospective Cohort Study.

ObjectivesThe effects of body mass index (BMI) on the outcome of high ligation and stripping (HLS) in an ambulatory center remain unclear. This study aims to investigate the outcomes of HLS in an ambulatory center based on BMI in the Chinese population.DesignThis was a prospective cohort study with mid-term follow-up.Materials and Methods170 eligible patients were included in the study and the data of Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, Venous Clinical Severity Score (VCSS), Visual Analogue Score (VAS), Aberdeen Varicose Veins Questionnaire (AVVQ), Quality of Recovery (QoR-15), and postoperative complications at predetermined time points were collected.ResultsA total of 170 patients (236 limbs) with a mean age of 53.87 ± 9.96 years (range, 24–80 years) and a mean BMI of 23.86 ± 2.96 kg/m2 were included. Of the group, 50.6% were women, and 66 patients received bilateral procedures. Through curve fitting, a BMI less than 28 and a BMI of 28 or higher were found to have a negative [−0.1 (−0.3, 0.1) 0.296] and positive [0.7 (0.2, 1.2) 0.006] relationship trend, respectively, with the improvement of VCSS at 6 weeks after surgery. Through smooth curve fitting, BMI was shown to have a negative relationship trend on the improvement of VCSS at 6 months after surgery. After multivariable risk adjustment for potential confounding factors, BMI was not found to be associated with the improvement of VCSS and AVVQ at 6 weeks after surgery, as well as the improvement of AVVQ at 6 months after surgery (all p-values >0.05). Six months after surgery, BMI was shown to have a negative relationship trend on the improvement of VCSS, and obese patients showed lower VCSS improvement than patients of normal BMI [−1.3 (−1.9, −0.7) <0.0001]. Six weeks after surgery, postoperative complications such as paresthesia were found to be significantly higher in the obese group than in the non-obese group (p < 0.05). At 6 months after surgery, the obese group showed significantly higher complications of the legs compared with the normal BMI group (p < 0.05).ConclusionsOur results showed that obesity is a risk factor for prognosis and postoperative complications following ambulatory HLS.

Varicose Vein Stripping in 66,577 patients in 11 years in public hospitals in São Paulo.

The aim of this study was to evaluate the epidemiology of varicose vein stripping in Brazil's largest city, São Paulo. Open and anonymous data regarding varicose vein surgeries between 2008 and 2018 were evaluated from the TabNet platform of the Municipal Health Secretary of São Paulo, Brazil. Most patients were female and adults. A total of 66,577 varicose vein surgeries were performed in public hospitals and outpatient clinics in São Paulo, with a statistically significant increase for both unilateral (p=0.003) and bilateral (p<0.001) procedures. Since 2016, unilateral procedures have been performed more frequently than bilateral procedures. Most procedures were associated with same-day (54.8%) or next-day (32%) discharge. The in-hospital mortality rate was 0.0045%. The total amount reimbursed was $20,693,437.94, corresponding to a mean value of $310.82 per procedure. Surgeries to treat chronic vein disease totaled 66,577 in 11 years, demanding $20,693,437.94 from the public health system. The majority of treated patients were female, over 40 years of age, and local residents. Procedure rates have increased over the years. The in-hospital mortality rate was very low (0.0045%).

Varicose Vein Stripping with Perforator Ligation Combined With Skin Grafting For Treatment of Venous Ulcers

Objective: To demonstrate the possibility of combining two procedures, GSV stripping with perforator ligation for varicose veins and skin grafting, to treat patients with venous ulcers related to reflux in saphenous vein. Combined procedure give early better disease free life and reduces ulcer related morbidity, socio economic burden, heath care burden. Methods: A total of 30 patients were treated during the study period of which of which 22 were male and 08 were females. Among 30 patients 26 had unilateral and 4 had bilateral ulcer. Ulcers were associated with concomitant reflux of the great saphenous vein. All 30 patients underwent GSV stripping with perforator ligation and split skin grafting in same sitting of surgery. The strategy employed began by harvesting skin from the donor area from the same limb. Great saphenous vein ligation with perforator ligation was done and skin graft placed over the varicose ulcer in the same sitting of surgery. Results: In all cases there was improvement of ulcer-related symptoms and healing of the lesion. In 28 cases we achieved full skin grafting viability. In 2 cases there was graft failure due to infection. Conclusion: This combination of procedures is a valid option, with the potential to provide quicker and less expensive treatment. Combined procedure give early better disease free life.

The Active Isoforms of MGP Are Expressed in Healthy and Varicose Veins without Calcification.

Matrix Gla protein (MGP), a local inhibitor of tissue mineralization, is associated with vascular calcification. Depending on the carboxylation and phosphorylation status, MGP has active conformations, e.g., carboxylated MGP (cMGP) and phosphorylated MGP (pMGP), but also inactive conformations, e.g., uncarboxylated MGP (ucMGP) and dephosphorylated MGP (dpMGP). Our purpose was to assess the presence of all MGP conformations in healthy veins (HV) and varicose veins (VV), concurrently with the analysis of circulating total MGP (tMGP) before and after the surgical stripping of VV. We collected samples from the great saphenous vein, considered as control group, and tissue from VV, designated as VV group. Plasma levels of tMGP were significantly decreased after the surgical removal of the VV (before 59.5 ± 17.2 vs. after 38.1 ± 11.3, p < 0.001). By using immunohistochemistry staining, we identified local cMGP and pMGP in the control and VV groups, both without calcification, while ucMGP and dpMGP were absent. cMGP was observed in the nucleus and cytoplasm and pMGP in the nucleus of cells belonging to the tunica media, tunica intima and vasa vasorum. Therefore, the active conformations of MGP (cMGP and pMGP) are prevalent in HV and VV without calcification, affirming their anti-calcifying role in veins.

Combined Lymphovenous Anastomosis and Great Saphenous Vein Stripping for Comorbid Lymphedema and Varicose Veins.

Background: Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate the validity of combined lymphovenous anastomosis (LVA) and great saphenous vein stripping (GSVS) for comorbid lymphedema and varicose veins. Methods: Thirteen patients were involved in the study, and the detail was 21 edematous lower limbs (with coexisting varicose veins and lymphedema; the varicose vein and lymphedema [VL] group) who underwent combined GSVS and LVA therapy. Fifteen patients (with 30 edematous lower limbs and lymphedema only; the lymphedema [L] group) who underwent LVA only were included as a control group. GSVS was performed before LVA in the VL group. Results: No significant differences were seen between the groups at baseline. There were no cases indocyanine green (ICG) lymphography pattern deteriorated after GSVS. No significant difference was seen in lymphatic detection rate; 129.71% ± 58.27% (67%-333%) in the VL group and 122.27% ± 39.47% (50%-250%) in the L group (p = 0.59 > 0.05), respective lymphatic diameters 0.66 ± 0.13 (0.45-0.9) mm and 0.75 ± 0.17 (0.45-1.0) mm (p = 0.07 > 0.05), and respective lymphedema improvement rate 12.17% ± 7.35% (0%-27.4%) and 12.65% ± 7.43% (3.7%-22.3%) (p = 0.86 > 0.05). Discussion: In this study, stripping surgery does not cause lymphatic impairment, at least to the extent that would impede the success of an LVA procedure. Comorbid varicose veins and lymphedema can be treated surgically by a combination of LVA and GSVS.

What is the best way to measure blood pressure?

In the treatment of Chronic Venous Insufficiency (CVI) High Ligation (HL) and stripping of the saphenous varicose veins,

A Case Study –Role of Leech Therapy (Jalaukavcharana)in Varicose Vein.

Varicose veins are saccular dilatations of veins that are frequently convoluted. Certain vocations, such as bus drivers and police officers, necessitate lengthy standing, and those who work in these positions are prone to varicose veins. It can also happento those who do a lot of muscle work, including rickshaw pullers and sportsmen. Varicose veins are often referred to Sirajagranthiin Ayurveda. According to Acharya Sushruta, Vata prakopaka nidanassuch as physical exertion and straining cause Vatato enter the Siras, creating Sampeedana, Sankocha, and Vishoshanaand triggering Granthiproduction in the Siras, displaying Sirajagranthi.Ayurveda reveals Raktamokshanaas a treatment for varicose veins. Raktamokshanawas done as Jalaukavacharana.This is a case study of a 36-year-old male patient with a history of varicose veins who complained of discomfort, muscular spasms, and blackish discoloration over the past three years. Before 5 years ago, he hada varicose vein stripping operation for the same issue. Jalaukavacharanawas performed once a week for one month. The patient had complete relief from all symptoms, as well as a noticeable improvement in the blackish discoloration of both legs.

Modification of varicose vein stripping to achieve immediate compression in a theatre setting with minimum personnel

Compression bandaging is a key aspect following stripping for varicose vein surgery. With adequate compression, formation of subcutaneous hematoma can be prevented and thereby prevent revascularisation of the hematoma leading to recurrence of varicose vein. Various techniques exist to provide compression. Our modification provides an easy alternative to achieve immediate compression following stripping and is especially useful in a setting where staff is very limited. Materials required include a 10 cm width gauze bandage, 1% lidocaine with epinephrine, and number 1 silk suture in addition to the conventional tools for open varicose vein surgery. The gauze bandage is introduced along with the stripper which is passed from groin to below knee. The bandage is kept in the subcutaneous tunnel till perforator ligation, groin wound closure and application of compression bandage. The gauze bandage is removed through a small window within the compression stocking below the knee and the wound closed in a single layer. From 2005 to 2020, 410 patients underwent varicose vein surgery with the modified technique. Of these, 1 patient developed complication secondary to hematoma formation which was managed conservatively. Our modification of the varicose vein stripping technique is shown to be a cost effective and simple technique which provides immediate compression and effortlessly facilitates haemostasis till wounds are closed and compression stockings applied. in various literatures.

Новый фактор послеоперационного венозного тромбоза в онкологии: миф или реальность?

Введение. Эндовенозная термическая абляция (ЭТА) поверхностных вен, включая лазерную абляцию или радиочастотную абляцию, широко применяется в лечении варикозной болезни нижних конечностей. Учитывая высокую частоту встречаемости варикозной болезни, частоту венозных тромбоэмболических осложнений (ВТЭО) после данного вмешательства, логично предположить, что выполнение ЭТА увеличит риск возникновения послеоперационного венозного тромбоза у онкологических больных. Существует недостаток данных о частоте ВТЭО в онкохирургии при ЭТА в анамнезе. Цель исследования: оценить влияние ранее проведенной ЭТА поверхностных вен нижних конечностей на послеоперационные ВТЭО в онкохирургии. Материалы и методы. Одноцентровое исследование с ретроспективным анализом онкологических больных на хирургическом этапе лечения злокачественных опухолей абдоминальной, гинекологической или урологической локализации проведено с мая 2013 г. по ноябрь 2018 г. В исследование были включены 36 пациентов, перенесших ЭТА более 3 мес назад (319 мес). Ультразвуковое дуплексное исследование вен нижних конечностей проводили перед операцией (за 110 дней) по поводу онкологического заболевания всем пациентам. Полная облитерация ствола большой подкожной вены (БПкВ) обнаружена в 66,7 случаев (n 24), реканализация в 33,3 (n 12). Все пациенты получали стандартную антикоагулянтную профилактику (надропарин по 0,4 мл/сут подкожно). Проведен морфологический анализ 3 случаев послеоперационного венозного тромбоза. Результаты. ВТЭО возникли в 20,8 (n 5) случаев при полной облитерации БПкВ, в 66,7 (n 8) с реканализацией ствола (95 ДИ 1,37,7) в послеоперационном периоде. Реканализация вены увеличила частоту развития послеоперационного венозного тромбоза в 3,2 раза. Заключение. ВТЭО часто возникают после неполной облитерации при ЭТА в отдаленном периоде при наличии дополнительных факторов риска. Учитывая широкое распространение данного типа операций во флебологии и возможность серьезных осложнений, необходимы дальнейшие исследования частоты венозного тромбоза при ЭТА в анамнезе у онкологических больных и определение стратегии профилактики ВТЭО. Introduction. Endovenous thermal ablation of saphenous vein (EVTA SV) including laser ablation or radiofrequency ablation widely used in varicose veins treatment of the lower extremities. EVTA SV can increase the risk of postoperative venous thrombosis in cancer patients. There is a deficiency of data examining rates of thrombotic events (VTE) in oncological patients. Aim: to assess influence of previously performed EVTA SV on postoperative VTE in oncosurgery. Materials and methods. This was a single centre study with retrospective analysis of consecutive oncological patients who underwent abdominal, gynecological or urological surgery from May 2013 to November 2018. 36 patients were included who underwent EVTA SV more than 3 month ago (319 months). Duplex ultrasound (DUS) was performed before oncological surgery (110 days). Complete SV obliteration was found in 66.7 of cases (n 24), recanalization in 33.3 (n 12). All patients had standard anticoagulant prophylaxis nadroparin 0.4 ml per day. We performed a morphologic analysis of 3 VTE cases. Results. Thrombotic complications occurred in 20.8 (n 5) of cases with complete SV obliteration, in 66.7 (n 8) with recanalization (95 CI 1.37.7). Recanalization of SV increased rate of postoperative cancer-associated VTE in 3.2 times. Conclusion. Thrombotic events occur frequently following incomplete obliteration after procedures EVTA SV. Taken account of the high rate of this procedures and the potential for serious consequences, further research is needed on VTE сomplications in oncology and their management.

Varicose vein surgery versus foam sclereotherapy to prevent extension of venous reflux with time

In the treatment of Chronic Venous Insufficiency (CVI) High Ligation (HL) and stripping of the saphenous varicose veins, and percutaneous phlebectomy have been the main options for many years. Modern management of CVI includes treatment of the cause (reflux) and result (varicose veins). Reflux should be treated before varicosities because if the cause is not eliminated, the varicose veins will recur [1].

Conventional versus invagination stripping varicose veins: which is better?

Background: Varicose veins are dilated, tortuous veins. It is an extremely common condition causing substantial morbidity. Prevalence of varicose veins ranges between 5% to 30% in adult population. Surgery is preferred over conservative treatment in symptomatic primary varicosis of the great saphenous vein (GSV). This study aims to compare the efficacy of GSV stripping by invagination technique in comparison to the conventional method in terms of time taken to strip the vein, the length of vein stripped, post-operative pain, area of bruising and intra-operative blood loss.Methods: The study was conducted in Dr. D. Y. Patil Medical College, Hospital and Research Centre located in Pimpri, Pune between July 2017 to September 2019.It is a prospective comparative Study. Subjects were randomly divided into 2 groups alternately where group A and B were operated by conventional and invagination techniques respectively and their outcomes were compared.Results: The mean age of the cases in Group A (conventional stripping) was 52 years and in group B (Invagination stripping) was 53 years. Blood loss was significantly more in conventional stripping compared to invagination stripping (p&lt;0.001). The post-operative (after 1 week) mean VAS of the cases in Group A was 3.1 and 2.3 respectively while in group B it was 2.9 and 2.1 respectively. Time taken to get back to activity was significantly more in conventional stripping compared to invagination stripping (p&lt;0.001).Conclusions: From this study we concluded that Invagination stripping is a suitable alternative to time honoured conventional varicose vein stripping with added advantage of less blood loss, less postoperative pain and shorter time span to get back to work.

Age is not a barrier to good outcomes following ambulatory high ligation and stripping for varicose veins: A prospective cohort study.

This was a prospective cohort study with a short-term follow-up. To explore whether age is a factor in the prognosis following high ligation and stripping (HLS) performed in an ambulatory care center. This study included 170 patients who underwent their first HLS for varicose veins in an ambulatory center from November 2016 to October 2017 at West China Hospital. The patients were categorized as two groups: the ≤60 years old group and the >60 years old group. We collected the two age groups data included Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, Venous Clinical Severity Score (VCSS), Visual Analogue Score (VAS), Aberdeen Varicose Veins Questionnaire (AVVQ), Quality of Recovery (QoR-15), and postoperative complications at predetermined time points. The clinical correlation between age and prognosis following HLS in an ambulatory care center was prospectively studied after adjusting for potential confounders. The distribution of age and prognosis were also compared in the AVVQ improvement and VCSS improvement of patients at 6 weeks and 6 months after surgery. Our research comprised a total of 170 patients (236 limbs), of which 86 (50.6%) patients were female and 66 (38.8%) patients received bilateral procedures. After multivariable risk adjustment for potential confounding factors, we observed that age was not associated with the improvement of AVVQ (OR 0.3, 95%CI (1.3, 0.7), P = .54) and VCSS (OR 0.2, 95%CI (0.2, 0.6) P = .38) at 6 months after HLS, as well as AVVQ (OR 0.5,95%CI (1.2, 2.2), P = .57) at 6 weeks after HLS. However, at 6 weeks after HLS, age was related to the improvement of VCSS (OR −0.6, 95%CI (1.2, 0.1), P = .03), with the >60 years old group having a lower VCSS improvement compared to the 60 years old group. In postoperative complications, there were no significant differences in terms of complications between the two age groups (all P value >.05). Therefore, in our opinion, age is not a barrier for good outcomes following HLS in an ambulatory care center.

Appropriate Surgical Treatment of Symptomatic Primary Varicose Veins Decreases Systemic Inflammatory Biomarkers.

Objective: To evaluate the relationship between systemic inflammatory biomarkers and efficacy of surgical treatment of primary varicose veins of the lower extremities.Methods: Total 12 patients who underwent endovenous laser ablation or stripping of varicose veins and six healthy subjects were enrolled. Structural and molecular changes of varices were assessed by immunohistochemical staining with anti-monocyte chemotactic protein-1 (MCP-1). MCP-1 and interleukin-6 (IL-6) levels in systemic antecubital blood were measured before and at 12 weeks after treatment.Results: Immunohistochemical staining revealed prominent manifestation of MCP-1-positive endothelial cells in the walls of varices. Preoperative serum MCP-1 and IL-6 levels in the patients were significantly higher than those in the control (166±12 pg/mL vs 99±10 pg/mL, p=0.003; 5.1±0.95 pg/mL vs 0.0±0.0 pg/mL, p=0.001, respectively). The values were significantly correlated with the severity of chronic venous insufficiency (CVI). Postoperative serum MCP-1 level significantly decreased compared with the preoperative level (152±10 pg/mL vs 166±12 pg/mL, p=0.048). The values after endovenous laser ablation did not significantly decrease compared with those after stripping.Conclusion: Varicose veins with CVI increase inflammatory biomarker levels in the local tissue and systemic blood. Appropriate treatment of symptomatic varicose veins decreases inflammatory biomarker levels.

Comparison of Endovenous Interventions Versus Stripping and Ligation for Varicose Veins Arising From the Popliteal Fossa

Comparison of Endovenous Interventions Versus Stripping and Ligation for Varicose Veins Arising From the Popliteal Fossa

Varicose vein ligation and stripping.

AORN JournalVolume 109, Issue 4 p. P9-P11 AORN Periop Briefing Varicose vein ligation and stripping First published: 28 March 2019 https://doi.org/10.1002/aorn.12680Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume109, Issue4Special Focus Issue: Ambulatory SurgeryApril 2019Pages P9-P11 RelatedInformation