Heredia PML, Serrano LJ, Sánchez NNE, Moreno RJC, Gutiérrez FJL

Language: Spanish
References: 14
Page: 57-61
PDF size: 304.13 Kb.

ABSTRACT

Introduction: The chronic venous insufficiency is the more frequent disease. More of 20% total surgeries are for recurrent varicose surgery. The causes of the recurrence are: technical error or neovascularization. The neovascularization is a normal part of wound repair sequence. The neovascularization diagnosis is by morphologic, histological, biochemical and Doppler Duplex Ultrasound findings.
Objective: To determinate the inguinal neovascularization incidence and varicose vein recurrence, on saphenofemoral stripping patients three years ago.
Material and methods: All saphenofemoral stripping surgeries done in 2004. With a new physical examination and a Colour Doppler Duplex Venous scan with a linear transductor 7.5 Mhz.
Results: A 118 total patients, divided in two groups: N group no recurrence, and V group with recurrence. 89 (75.4%) no recurrence and 29 (24.5%) with recurrence. 11 (12.98%) patients with atypical veins in the groin by ultrasound; seven (8%) N group patients (no recurrence) and four (14%) V group patients (with recurrence); 8% of the N group patients with atypical veins on the groin with Doppler Duplex scan, but without varicose vein in the legs; 14% on the V group patients, with atypical veins on the groin and were associated with varicose vein on the legs.
Conclusions: The new varicose veins on the proximal leg are clinical recurrence, but no always ultrasonografic recurrence. The Colour Doppler Duplex scan is very important on the varicose vein recurrence patients, to determinate the causes and determinate de best treatment

REFERENCES

1. Merlo I, Parente Ben Hur J. Várices y telangiectasias. Diagnóstico y Tratamiento. AMOLCA 2007.

2. Geier B, Olbrich S. Validity of the macroscopic identifica tion of neovascularization at the saphenofemoral junction by the operating surgeon. J Vasc Surg 2005; 41(1): 64 8.

3. Stucker M, Netz C. Histomorphologic clasification of recu rrent saphenofemoral reflux. J Vasc Surg 2004; 39(4): 816 21.

4. Perrin MR, Labropoulos N. Presentation of the patient with recurrent varices after surgery (REVAS). J Vasc Surg 2006; 43(2): 327 34.

5. Fischer R, Linde N. Late recurrent saphenofemoral junc tion reflux after ligation and stripping of the greater saphe nous vein. J Vasc Surg 2001; 34(2): 236 40.

6. Mosel Eifel Klinik. Reduction of neoreflux after correctly performed ligation of the saphenofemoral junction. A Randomized trial. Eur J Vasc Endovasc Surg 2004; 28: 246 52.

7. Winterborn RJ, Foy C. Causes of varicose vein recurren ce: Late results of a randomized controlled trial of strip ping the long saphenous vein. J Vasc Surg 2004; 40(4): 634 9.

8. Kostas T, Ioannou CV. Recurrent varicose veins after sur gery: A new appraisal of a common and complex problem in vascular surgery. Eur J Vasc Endovasc Surg 2004; 27: 275 82.

9. van Rij AM, Jones GT. Neovascularization and recurrent varicose veins: More histologic and ultrasound evidence. J Vasc Surg 2004; 40(2): 296 302.

10. Fischer R, Chandler JG. Patient characteristics and physi cian determined variables affecting saphenofemoral re flux recurrence after ligation and stripping of the great saphenous vein. J Vasc Surg 2006; 43(1): 81.e1 81.e8.

11. Wong JKF, Duncan JL. Whole leg mapping for varicose veins: Observations on patterns of reflux in recurrent and primary legs, with clinical correlation. Eur J Vasc Endo vasc Surg 2003; 25: 267 75.

12. Coleridge Smith P, Labropoulos N. Duplex ultrasound in vestigation of the veins in chronic venous disease of the lo wer limbs UIP Consensus document. Part I. Basic princi ples. Eur J Vasc Endovasc Surg 2006; 31: 83 92.

13. Cavezzi A, Labropoulos N. Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs UIP Consensus document. Part II. Anatomy. Eur J Vasc Endovasc Surg 2006; 31: 288 9.

14. Ali SM, Callam MJ. Results and significance of colour du plex assessment of the deep venous system in recurrent va ricose veins. Eur J Vasc Endovasc Surg 2007; 34: 97 101.