ABSTRACT
Varicose veins are a common condition that the current paper elaborates the features of the condition in a local Indian population. This prospective clinical study of surgical management of varicose vein was conducted to study the age, sex and occupational distribution of varicose veins of lower limb. Evaluations of clinical features and surgical methods of treatments that were in practice in the management of varicose veins in terms of recurrence and symptoms improvement were also studied. Methods: Two years prospective study was conducted in our institution from April 2016 to March 2018. During this period 68 cases of varicose veins of lower limbs were admitted to our hospital of which 60 cases were selected and were studies in detail. After thorough clinical examination and relevant investigation they are all subjected to surgical management. Results: Out of 60 cases studied, 31 (62%) had only long saphenous vein involvement, 7 (14%) had short saphenous vein involvement and in 5 (10%) cases both short and long saphenous system were involved. In addition to long saphenous vein involvement, incompetent perforators were present in 17 (34%) cases. Among them prominent veins and pain were the main complain in 38 (78%) patients. Itching and pigmentation were present in 4 (8%) patients. Ankle edema was present in 6 (12%) patients. Pain and ulceration of lower leg were present in 2 (4%) patients. After clinical assessment appropriate surgical procedures were followed for each of patients. These cases were followed for 3 year durations. Out of 60 patients 7 (14%) patients had recurrence of varicose vein. 7 (14%) patient complained of recurrence of pain after 2 years of surgery but no appearance of varicose vein. One patient complained of persistence of pigmentation after surgery. 2 patients complained of persistence of ankle edema and there was complete healing of ulcer which was present earlier. Conclusion: Commonest age group of varicose vein of lower limb was 20 to 40 years. Definite relationship exists between the occupation and the incidence of varicose veins. The patients were in the occupation which required standing for long time had the higher chances of varicose vein. Severity of the symptoms is not proportional to the duration of varicose veins. The involvement of long saphenous vein is more common than the short saphenous vein. Since our study shows very low percentage of recurrence and symptoms related to varicose vein the surgical line of treatment is an ideal treatment for varicose vein. For incompetent perforators, sub-fascial ligation appears to be a better method of treatment than extra fascial ligation. Because in the former all the perforators could be visualized and dealt with, while in the latter there were chances of missing one or two perforators. If cases are selected properly with good operative technique the complications are negligible.
ABSTRACT
A Síndrome da Congestão Venosa Pélvica (SCVP) é uma causa de dor pélvica crônica, que afeta principalmente mulheres multíparas em idade reprodutiva. Para o tratamento desta síndrome, a embolização de varizes pélvicas tem demonstrado excelentes resultados. Relatamos uma série inicial de pacientes submetidas a tratamento com embolização de varizes pélvicas e os respectivos resultados de acompanhamento pós-operatório. São apresentados dados clínicos, detalhes do procedimento e resultados do acompanhamento e de exames de imagem de seis pacientes. Dentre estas pacientes, o sucesso técnico foi de 100% e não houve relato de complicações trans ou pós-operatórias graves. Em todos os casos, pôde-se observar alívio dos sintomas e melhora nos resultados de exames de imagens no acompanhamento de curto prazo. Os resultados nesta pequena série de casos indicam que a embolização é um tratamento seguro e efetivo para a SCVP.
Pelvic Congestion Syndrome (PCS) is a cause of chronic pelvic pain that primarily affects multiparous women of reproductive age. Embolization of pelvic varicose veins offers excellent results for treatment of this syndrome. We describe an initial series of patients treated with embolization of pelvic varicose veins and their respective postoperative follow-up results. We provide clinical data, details of the procedures performed and results of follow-up and imaging exams for six patients. The technical success rate with these patients was 100% and there were no reports of serious intraoperative or postoperative complications. In all cases there was relief from symptoms and improvements in the results of imaging exams during short-term follow-up. The results of this small series of cases indicate that embolization is a safe and effective treatment for PCS.