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Article: Reduction in deep vein reflux after concomitant subfascial endoscopic perforating vein surgery and superficial vein ablation in advanced primary chronic venous insufficiency

TitleReduction in deep vein reflux after concomitant subfascial endoscopic perforating vein surgery and superficial vein ablation in advanced primary chronic venous insufficiency
Authors
Issue Date2006
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jvs
Citation
Journal Of Vascular Surgery, 2006, v. 43 n. 3, p. 546-550 How to Cite?
AbstractBackground: Subfascial endoscopic perforating vein surgery (SEPS) and superficial vein surgery (SVS) have been the recommended treatment for advanced chronic venous insufficiency (CVI), despite a high prevalence of deep vein reflux in these patients. The anatomic and hemodynamic results of these procedures, however, remain uncertain. It is hypothesized that concomitant SEPS and SVS would result in a reduction of deep vein reflux in patients with advanced primary CVI. We investigated the effect of concomitant SEPS and SVS on deep vein reflux as well as the associated hemodynamic and clinical changes after surgery in a cohort of patients with advanced primary CVI. Methods: We prospectively evaluated 53 consecutive SEPSs with concomitant SVS procedures in 47 patients with advanced primary CVI. There were 25 men and 22 women with a mean age of 58 years at operation. Thirty-four procedures (64%) were performed for limbs with active venous ulcers (class 6), and the other 19 procedures were performed for 15 class 5 limbs, one class 4a limb, and three class 4b limbs, respectively. Duplex scan and air plethysmography were performed before operation, at 1 month, and at 1 year after operation. The patients were followed up regularly with clinical assessment, and the ulcer healing and recurrence rates were documented. Results: The proportion of limbs with common femoral vein incompetence decreased from 68% to 28% at 1 month and to 32% at 1 year after operation. The proportion of limbs with deep vein incompetence at more than one site also decreased from 42% to 15% at 1 month and to 12% at 1 year after concomitant SEPS and SVS. Venous hemodynamics as measured by air plethysmography improved significantly after operation. The cumulative ulcer healing was 85% at 3 months and 97% at 6 months. With a mean follow-up of 31 ± 16 months, all ulcers healed. Only three recurrent ulcers (6%) were detected during the follow-up period. Conclusion: Concomitant SEPS and SVS are effective in reducing deep vein reflux and results in hemodynamic and clinical improvements in patients with advanced primary CVI. Deep vein reconstruction procedures may not be necessary in these patients. Copyright © 2006 by The Society for Vascular Surgery.
Persistent Identifierhttp://hdl.handle.net/10722/83666
ISSN
2015 Impact Factor: 3.454
2015 SCImago Journal Rankings: 2.115
ISI Accession Number ID
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.accessioned2010-09-06T08:43:45Z-
dc.date.available2010-09-06T08:43:45Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Vascular Surgery, 2006, v. 43 n. 3, p. 546-550en_HK
dc.identifier.issn0741-5214en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83666-
dc.description.abstractBackground: Subfascial endoscopic perforating vein surgery (SEPS) and superficial vein surgery (SVS) have been the recommended treatment for advanced chronic venous insufficiency (CVI), despite a high prevalence of deep vein reflux in these patients. The anatomic and hemodynamic results of these procedures, however, remain uncertain. It is hypothesized that concomitant SEPS and SVS would result in a reduction of deep vein reflux in patients with advanced primary CVI. We investigated the effect of concomitant SEPS and SVS on deep vein reflux as well as the associated hemodynamic and clinical changes after surgery in a cohort of patients with advanced primary CVI. Methods: We prospectively evaluated 53 consecutive SEPSs with concomitant SVS procedures in 47 patients with advanced primary CVI. There were 25 men and 22 women with a mean age of 58 years at operation. Thirty-four procedures (64%) were performed for limbs with active venous ulcers (class 6), and the other 19 procedures were performed for 15 class 5 limbs, one class 4a limb, and three class 4b limbs, respectively. Duplex scan and air plethysmography were performed before operation, at 1 month, and at 1 year after operation. The patients were followed up regularly with clinical assessment, and the ulcer healing and recurrence rates were documented. Results: The proportion of limbs with common femoral vein incompetence decreased from 68% to 28% at 1 month and to 32% at 1 year after operation. The proportion of limbs with deep vein incompetence at more than one site also decreased from 42% to 15% at 1 month and to 12% at 1 year after concomitant SEPS and SVS. Venous hemodynamics as measured by air plethysmography improved significantly after operation. The cumulative ulcer healing was 85% at 3 months and 97% at 6 months. With a mean follow-up of 31 ± 16 months, all ulcers healed. Only three recurrent ulcers (6%) were detected during the follow-up period. Conclusion: Concomitant SEPS and SVS are effective in reducing deep vein reflux and results in hemodynamic and clinical improvements in patients with advanced primary CVI. Deep vein reconstruction procedures may not be necessary in these patients. Copyright © 2006 by The Society for Vascular Surgery.en_HK
dc.languageengen_HK
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jvsen_HK
dc.relation.ispartofJournal of Vascular Surgeryen_HK
dc.rightsJournal of Vascular Surgery. Copyright © Mosby, Inc.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshChronic Diseaseen_HK
dc.subject.meshEndoscopy - methodsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshVeins - physiopathologyen_HK
dc.subject.meshVenous Insufficiency - physiopathology - surgeryen_HK
dc.titleReduction in deep vein reflux after concomitant subfascial endoscopic perforating vein surgery and superficial vein ablation in advanced primary chronic venous insufficiencyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0741-5214&volume=43&issue=3&spage=546&epage=550&date=2006&atitle=Reduction+in+deep+vein+reflux+after+concomitant+subfascial+endoscopic+perforating+vein+surgery+and+superficial+vein+ablation+in+advanced+primary+chronic+venous+insufficiencyen_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.doi10.1016/j.jvs.2005.11.020en_HK
dc.identifier.pmid16520170-
dc.identifier.scopuseid_2-s2.0-33644682484en_HK
dc.identifier.hkuros115604en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33644682484&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume43en_HK
dc.identifier.issue3en_HK
dc.identifier.spage546en_HK
dc.identifier.epage550en_HK
dc.identifier.isiWOS:000235848800021-
dc.publisher.placeUnited Statesen_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

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