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Article: Surgical treatment for advanced chronic venous insufficiency in Hong Kong

TitleSurgical treatment for advanced chronic venous insufficiency in Hong Kong
Authors
KeywordsChronic venous insufficiency
Subfascial endoscopic perforating vein surgery
Surgical treatment
Issue Date2004
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ASH
Citation
Annals Of The College Of Surgeons Of Hong Kong, 2004, v. 8 n. 4, p. 135-140 How to Cite?
AbstractAdvanced chronic venous insufficiency (CVI) is an important health problem. In Hong Kong, with its predominantly Chinese population, most patients have primary CVI because deep vein thrombosis is less common. Nevertheless, 80% of the limbs with advanced CVI had reflux in both the superficial and deep vein systems. This showed that advanced CVI in this population is a multisystem pathological condition affecting both the superficial and deep vein systems. In the present study, it was hypothesized that the abnormal hydrostatic forces in the superficial and perforating vein systems are the significant pathologic forces leading to advanced CVI, although deep vein incompetence is common. This deep vein incompetence can be contributed to significantly by venous overload as a result of superficial reflux (reflux circuit of venous overload). This is well supported by the abolition of deep venous reflux as well as significant haemodynamic improvement as measured by air plethysmography after superficial vein surgery in limbs with mixed superficial and deep venous incompetence. Recently, subfascial endoscopic perforating vein surgery (SEPS) was introduced as a minimally invasive technique to interrupt incompetent calf perforators. Preliminary local experience showed that SEPS with concomitant superficial vein surgery was associated with a 97% ulcer healing at a mean follow up of 15 months. Significant haemodynamic improvement was also shown by air plethysmography. However, recurrent ulcers were noted in 15% of the limbs. Thus, SEPS with superficial vein surgery where appropriate can be the optimal operative treatment strategy for advanced CVI in the local population, although ulcer recurrence remains a concern.
Persistent Identifierhttp://hdl.handle.net/10722/83232
ISSN
References

 

DC FieldValueLanguage
dc.contributor.authorTing, ACWen_HK
dc.contributor.authorCheng, SWKen_HK
dc.contributor.authorHo, Pen_HK
dc.contributor.authorPoon, JTCen_HK
dc.contributor.authorWu, LLHen_HK
dc.contributor.authorCheung, GCYen_HK
dc.date.accessioned2010-09-06T08:38:34Z-
dc.date.available2010-09-06T08:38:34Z-
dc.date.issued2004en_HK
dc.identifier.citationAnnals Of The College Of Surgeons Of Hong Kong, 2004, v. 8 n. 4, p. 135-140en_HK
dc.identifier.issn1028-4001en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83232-
dc.description.abstractAdvanced chronic venous insufficiency (CVI) is an important health problem. In Hong Kong, with its predominantly Chinese population, most patients have primary CVI because deep vein thrombosis is less common. Nevertheless, 80% of the limbs with advanced CVI had reflux in both the superficial and deep vein systems. This showed that advanced CVI in this population is a multisystem pathological condition affecting both the superficial and deep vein systems. In the present study, it was hypothesized that the abnormal hydrostatic forces in the superficial and perforating vein systems are the significant pathologic forces leading to advanced CVI, although deep vein incompetence is common. This deep vein incompetence can be contributed to significantly by venous overload as a result of superficial reflux (reflux circuit of venous overload). This is well supported by the abolition of deep venous reflux as well as significant haemodynamic improvement as measured by air plethysmography after superficial vein surgery in limbs with mixed superficial and deep venous incompetence. Recently, subfascial endoscopic perforating vein surgery (SEPS) was introduced as a minimally invasive technique to interrupt incompetent calf perforators. Preliminary local experience showed that SEPS with concomitant superficial vein surgery was associated with a 97% ulcer healing at a mean follow up of 15 months. Significant haemodynamic improvement was also shown by air plethysmography. However, recurrent ulcers were noted in 15% of the limbs. Thus, SEPS with superficial vein surgery where appropriate can be the optimal operative treatment strategy for advanced CVI in the local population, although ulcer recurrence remains a concern.en_HK
dc.languageengen_HK
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ASHen_HK
dc.relation.ispartofAnnals of the College of Surgeons of Hong Kongen_HK
dc.subjectChronic venous insufficiencyen_HK
dc.subjectSubfascial endoscopic perforating vein surgeryen_HK
dc.subjectSurgical treatmenten_HK
dc.titleSurgical treatment for advanced chronic venous insufficiency in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.emailCheng, SWK: wkcheng@hkucc.hku.hken_HK
dc.identifier.emailPoon, JTC: tcjensen@hkucc.hku.hken_HK
dc.identifier.authorityCheng, SWK=rp00374en_HK
dc.identifier.authorityPoon, JTC=rp01603en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1442-2034.2004.00221.xen_HK
dc.identifier.scopuseid_2-s2.0-10444232705en_HK
dc.identifier.hkuros97144en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10444232705&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume8en_HK
dc.identifier.issue4en_HK
dc.identifier.spage135en_HK
dc.identifier.epage140en_HK
dc.publisher.placeAustraliaen_HK
dc.identifier.scopusauthoridTing, ACW=7102858552en_HK
dc.identifier.scopusauthoridCheng, SWK=7404684779en_HK
dc.identifier.scopusauthoridHo, P=24469553100en_HK
dc.identifier.scopusauthoridPoon, JTC=7005903722en_HK
dc.identifier.scopusauthoridWu, LLH=7404903103en_HK
dc.identifier.scopusauthoridCheung, GCY=15052803300en_HK
dc.identifier.citeulike66688-

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