Stripping Operation with Preservation of the Calf Saphenous Veins for Primary Varicose Veins: Hemodynamic Evaluation

Abstract

Purpose.

To study early changes in venous hemodynamics in stripping operation with preservation of the calf saphenous veins.

Patients and methods.

From October 1999 to December 2000, 110 extremities of 73 patients were treated for primary varicose veins. Based on preoperative ascending venography, 40 extremities underwent the groin-to-knee stripping of the GSV, 20 underwent the proximal division of the LSV, and 50 received combinations of both surgeries. To evaluate venous hemodynamic changes, air plethysmography was performed before operation and 7–14 days after operation.

Results.

The venous volume, venous filling index and residual volume fraction were improved after surgery, but the ejection fraction did not change. The overall incidence of nerve injury was 4.5% (five limbs).

Conclusions.

In stripping operations, the preservation of the calf saphenous veins, which is shown to be advantageous in reducing saphenous or sural nerve injuries, does not adversely affect early venous hemodynamic improvement.

Keywords

Varicose vein Saphenous vein Hemodynamics Venous insufficiency

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References

Wellwood

J. M.

, Cox

S. J.

, Martin

Sensory changes following stripping of the long sphenous vein. J. Cardiovasc. Surg., 1975, 16, 123–124.

Negus

Should incompetent saphenous veins be stripped to right down the ankle?

Phlebologie, 1987, 40, 753–757.

Koyano

and Sakaguchi

Selective stripping operation based on doppler ultrasonic findings for primary varicose veins of the lower extremities. Surgery, 1988, 103, 615–619.

Munn

S. R.

, Morton

J. B.

, Macbeth

W. A. A. G.

To strip or not to strip the long saphenous vein? A varicose vein trial. Br. J. Surg., 1981, 68, 426–128.

Beebe

H. G.

, Bergan

J. J.

, Bergqvist

Classification and grading of chronic venous disease in the lower limb. A consensus statement. Int. Angiol., 1995, 14, 197–201.

Rivlin

The surgical cure of primary varicose veins. Br. J. Surg., 1975, 62, 913–917.

Labropoulos

, Mansour

M. A.

, Kang

S. S.

New insights into perforator vein incompetence. Eur. J. Vasc. Endovasc., 1999, 18, 228–234.

Christopoulos

D. G.

, Nicolaides

A. N.

, Szendro

Air-plethysmography and the effect of elastic compression on venous hemodynamics of the leg. J. Vasc. Surg., 1987, 5, 148–159.

Christopoulos

D. G.

, Nicolaides

A. N.

, Galloway

J. M. D.

Objective noninvasive evaluation of venous surgical results. J. Vasc. Surg., 1988, 8, 683–687.

10.

Gillespie

D. L.

, Cordts

P. R.

, Hartono

The role of air plethysmography in monitoring the result of venous surgery. J. Vasc. Surg., 1992, 16, 674–678.

11.

Padberg

F. T.

, Pappas

P. J.

, Araki

C. T.

Hemodynamic and clinical improvement after superficial ablation in primary combined venous insufficiency with ulceration. J. Vasc. Surg., 1996, 24, 711–718.

12.

Sarin

, Scurr

J. H.

and Smith

Coleridges

, Stripping

P. D.

Operation of the long saphenous vein in the treatment of primary varicose veins. Br. J. Surg., 1994, 81, 1455–1458.

13.

Neglen

, Einarsson

and Eklof

B. T.

The functional long-term value of different types of treatment for saphenous vein incompetence. J. Cardiovasc. Surg., 1993, 34, 295–301.

14.

Rutgers

P. H.

and Kitslaar

P. J. R.

Randomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am. J. Surg., 1994, 168, 311–315.