Study on foam sclerotherapy for varicose veins of lower extremities / 临床外科杂志

Objective To explore the relationship between recurrence rate and side effects of the treatment of varicose veins in lower extremity with lauromacrogol foam sclerosing agent.Methods The data of 62 patients(98 limbs)with varicose veins was collected,including 27 males (41 limbs)and 35 females (57 limbs).They were treated with 1％ lauromacrogol foam sclerosing agent combined with great saphenous vein high ligation and endovenous laser treatment.Statistical indicators included side effects such as pain,induration,hyperpigmentation,swelling,numbness and the recurrence rate.Results Two patients were lost,57 patients were injected once,further foam sclerotherapy was carried out again for 3 patients.Obvious abnormal varicose veins as well as the soreness and fatigue of lower extremity disappeared in all patients.Thirty-seven patients had pain and 43 patients developed superficial venous thrombotic sclerosis,among which 50 patients faded away after 1 to 3 months by taking diosmin.Thirty-one cases of pigmentation occurred and 20 disappeared after 1 to 3 months by applying the vitamin E whitening essence.Six patients with lower extremity ulcers recovered after 1 to 3 months.Through statistics analysis of the patients in 1-month follow-up,we found that the differences in recurrence rate after 6 months were statistically significant between group with pain induration reaction and group without (P ＜ 0.05).Among the patients without using the vitamin E whitening essence,there was a significant correlation between the duration of pigmentation and recurrence rate after 6 months.Conclusion In the process of foam sclerotherapy,the more pain induration reaction they had and the longer the duration of pigmentation sustained,the lower the recurrence rate would be accordingly.

Observation and clinical study of left lower limb great saphenous vein double backbone variations / 局解手术学杂志

Objective To observe the left lower limb great saphenous vein double backbone variations and then conclude correlated var -iation with articles and essays which can offer basic data reference for correlational research and treatment .Methods A male adult corpse fixed by 10%formalin was dissected , and the aberrant vessels were measured by digital caliper and Digimizer .Collected essays and articles about variation of great saphenous vein and its tributary on CNKI from January 1,2000 to May 1,2016.Results There were two major vein of left lower limb great saphenous vein from feet to foramen of saphenous vein of this corpse .The common variations of great saphenous vein and its tributary included variation of quantity and position .Conclusion The variations of great saphenous vein and its tributary do not exist alone.There are usually several variants exist together .So,taking an imaging examination before the operation of great saphenous varicose veins is the key of preventing vessels from injury and reducing the happening of complication .

The application value of CT phlebography scan on communicating veins in treating varicose vein of the lower extremity / 实用放射学杂志

respectively)was significantly higher than that for digital anterograde venography (0.684 and 0.587,P =0.026,respectively).Conclusion Diagnostic accuracy and detection rate of residuaI or recurrent varicose veins with CT phlebography are found to be more superior than that with digital anterograde venography which has high guidance value in preoperation and assesses the efficacy of post-surgery treatment.

Comparison of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity / 中国综合临床

Objective To compare the efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity. Methods From January 2014 to January 2015,77 patients diagnosed as great saphenous varicosity were enrolled. They were randomly divided into two groups, 37 patients received endovenous laser treatment combined with transilluminated powered phlebectomy and the other 40 patients underwent traditional surgical treatment. The related indicators were compared.Results The mean operation time,average bleeding volume,operative incisionquantity and average hospitalization time of EVLT+ TIPP group were (66.1±14.7) min,(24.4±10.5) ml,5.7±1.7,(5.6±1.4) d respectively,of control group were (84.3±18.5) min,(59.0±15.6) ml,8.0±1.8,(10.1±3.1) d respectively,there were significant differences between the two groups(t =-4.749,-11.460,-5.714;P0.05).During a mean follow?up time of (18±7) months(12 months to 24 months),1 patient recurrence in theEVLT+ TIPP group,2 cases recurrence in the traditional operation group.The recurrence rates of the two groupswere similar,the difference was not significant between them(P=1.000) .Conclusion Endovenous lasertreatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective andsafe.It also has the advanta and better cosmetic results.

Klippel-Trenaunay Syndrome - A Case Report.

Klippel-Trenaunay Syndrome (KTS) is a sporadic disorder characterized by the triad of vascular malformation (capillary hemangioma or port wine stain), venous varicosity and soft tissue and/ or bony hypertrophy. We report here a case of Klippel-Trenaunay syndrome with review of literature.

Round ligament varicosities mimicking inguinal hernia in pregnancy / 대한외과학회지

Round ligament varicosities during pregnancy are rare, and can easily be mistaken for an inguinal hernia. On physical examination, round ligament varicosities and groin hernia are difficult to distinguish. The diagnosis of round ligament varicosities can be established on gray-scale and color Doppler sonography. We experienced a case of round ligament varicosities in which a 29-year-old woman presented symptoms at 36 weeks gestation. The patient was diagnosed using Doppler sonography, managed with conservative therapy, and had an uncomplicated vaginal delivery at 40 weeks. The symptoms were resolved completely by two weeks postpartum. We report a case of round ligament varicosities that was diagnosed at 36 weeks of gestation with a review of the literature.

A case of round ligament varicosities during pregnancy / 대한산부인과학회지

Estimated incidence of round ligament varicosities in pregnancy is not known and often times it is confused with inguinal hernia due to their clinical similarities. When a patient is presented with inguinal mass especially in association with varicosity in the genital region or lower extremity, round ligament varicosity must be considered as a plausible diagnosis. Depiction of "bag of worms" on color Doppler ultrasonography is diagnostic of the round ligament varicosity and it is known to resolve spontaneously following delivery. We report a case of round ligament varicosities that was diagnosed at 29 weeks of gestation with a brief review of the literatures.

Short Term Results of Endovenous Laser Treatment with Ultrasound Guided Ligation of the Sapheno-femoral Junction or Sapheno-popliteal Junction in Patients with Varicose Vein

PURPOSE: The main cause of recurrence of varicosity after endovenous laser treatment (EVLT) is incomplete occlusion of the sapheno-femoral junction (SFJ) or the sapheno-popliteal junction (SPJ). To reduce the recurrence and complications of EVLT, we have tried to ligate the SFJ or SPJ under ultrasonic guidance. METHOD: Two separate parallel punctures were made under ultrasonic guidance 1 cm inferior to and alongside the SFJ or SPJ with using a 16 gauge needle. A hook was passed through beneath the saphenous vein and it was pulled out through the puncture holes. A black silk thread was passed through backward with the hook and then the thread was tied. Low energy EVLT was then performed in a continuous fashion with using a 980 nm multidiode laser. RESULT: Between December, 2007 and February, 2008, 21 patients (males: 14, females: 7, 28 legs, mean age: 45 years old) with including 20 great saphenous veins (GSV) and 8 small saphenous veins (SSV) were managed using our protocol. The mean energy density (ED) was 9.8J/cm for the GSV and 9.5J/cm for the SSV. The pullback speed on the fiber was 69.5 sec at the GSV and 28sec at the SSV. No recurrence was noted. The complications were bruise (7 limbs/24%), fibrotic cord (4 limbs/14%), pain (8 limbs/31%), inguinal pain and paresthesia (1 limb/3%) and hematoma (4 limbs/14%). These complications were well controlled without any further problems. CONCLUSION: During EVLT, ultrasound (US) guided ligation of the SFJ is cosmetically satisfactory and effective in reducing the amount of required endovenous laser energy. The complication rate and severity were not reduced, but they under control.

Clinical comparative study on conventional surgical and subfascial endoscopic perforator surgery in great venous varicosity / 中国基层医药

Objective To compare the curative effect of high ligation+exfoliation and subfascial endoscopic perforator surgery(SEPS)for superficial varicose veins in calf+invagination spot-striping surgery in great venous varicosity.Methods Study group(42 patients)accepted SEPS+invagination spot-striping surgery and control group (42 patients)accepted traditional surgeries.Operation duration,bleeding volume in operation,the time of beginning movement away from bed after operation,hospitalization duration,the degree of pain,the scar,the recrudescence af- ter operation and the instance of the ulcer heals of two groups were compared.Results Operation duration,bleeding volume in operation,the time of begin movement away from bed after operation and hospitalization durations of study group were significantly lower than those of control group(P0.05).All of the patients in study group recovered without severe syndromes such as venous thrombosis,skin necrosis,lower limb functional disorder etc.They had no recrudesce after 4～16 months and were satisfied with the curative effect.Con- elusions The clinical curative effect of SEPS+invagination spot-striping surgery in great venous varicosity is superi- or to that of traditional operation and it has the advantages such as minor wound,few scars,light pains,short hospi- talization duration,without recrudescence,the ulcer heals quickly and so on.

Treatment of great saphenous varicosity by inserting optical fiber straigat into EVLT / 中国基层医药

Objective To investigate the methods of treating great saphenous varicosity by inserting optical fiber straight into EVLT.Methods Wuhan Linyun Laser Therapeutic System was introduced to treat 205 cases (257 limbs)of great saphenous varicosity.Optical fiber instead of blood vessel sheath and catheter was inserted straight into endovenous laser treatment(EVLT)through arteriovenons permanent needle was adopted.Results Operations lasted 35～55 minutes,averaging 45 minutes.Patients were hospitalized for 5～7 days.Postoperative vis- its were followed for 3～12 months,averaging 6 months.Two months after the operation,appraisal according to the curative effect evaluation criteria was carried on.The cure rate for superficial varicosity is 97.3%(250/257),for lower extremities swelling asthenia is 93.7%(150/160),for skin pigmentation is 91.8%(56/61),and for swelling is 90.9%(20/22).10 cases(3.9%)suffered from skin ambustion.9 cases(3.5%)suffered from shank anesthesia and stabbing pain.15 cases(5.8%)suffered from hypodermic tubercle.The patients had not deep venous thrombosis after the operation and the wounds healed well.Conclusion Inserting optical fiber straight into EVLT through arte- riovenous permanent needle brings about more accurate treatment.It can be operated simply,causing small wounds and less pain.

Comparison of Immediate Therapeutic Effects Between Endovenous Laser Treatment and Conventional Surgical Therapy for Lower Extremity Varicosity / 中国普外基础与临床杂志

Objective To compare the immediate therapeutic effects between endovenous laser treatment and conventional surgery for lower extremity varicosity.Methods Data of 350 limbs of 275 patients treated by endovenous laser treatment (endovenous laser treatment group) and 310 limbs of 210 patients by traditional surgery (traditional surgery group) were analyzed and compared in terms of operation time,number of the incision,postoperative pain,complications,postoperative hospitalized duration and 1-year recurrence rate.Results Endovenous laser treatment group had shorter operation time,fewer incisions,less postoperative pain and shorter postoperative hospitalized duration than traditional surgery group (P0.05).Conclusion As a safe and effective new treatment for lower extremity varicosity with minimal invasiveness and no left scars,endovenous laser treatment has the potential to replace conventional surgery and extend the surgical indications for lower extremity varicosity treatment.

High Ligation with Sclerotherapy for Lesser Saphenous Varicose Veins

PURPOSE: The purpose of this study was to determine the validity of high ligation of saphenopopliteal junction with sclerotherapy under local anesthesia in the management of lesser saphenous vein varicosity. METHOD: Between September, 1998 and June, 2000, we managed 37 patients of lesser saphenous vein varicosity and the clinical records were reviewed retrospectively. The patients were divided into two groups: one was 27 patients treated by high ligation of saphenopopliteal junction with sclerotherapy group under local anesthesia, and the other was 10 patients by stripping of lesser saphenous vein with stab avulsion group under general anesthesia. We compared the two groups on the basis of number of sclerotherapy after operation, recurrence, total cost and measure of health outcome with Aberdeen Varicose Veins Questionnaire. Of 37 patients, 20 patients in the high ligation group and 8 patients in the stripping group were available to follow-up with telephone. The differences between groups were tested with Mann-Whitney test. RESULT: The mean age was 42.4+/-8.1 year for the high ligation group and 47.1+/-12.2 year for the stripping group and the male to female ratio was 1:5.5 and 1:2.3 respectively. The mean number of sclerotherapy after first treatment was significantly more in high ligation group than stripping group (1.4 vs 0.3; P<0.001). The mean total cost was significantly higher in the stripping group than high ligation group (646,102 won vs 323,184 won; P=0.001). There was only one case of recurrence in the high ligation group. No statistical differences could be found between the two group concerning mean score of Aberdeen Varicose Veins Questionnaire (11.10 vs 10.13; P=0.953). CONCLUSION: We conclude that the high ligation of saphenopopliteal junction with sclerotherapy under local anesthesia is very effective and sufficient treatment modality in the management of lesser saphenous vein varicosity.

Laser Treatment Combined with High Ligation of the Great Saphenous Vein for Varicose Veins in the Lower Extremities: Clinical Analysis of 46 Cases / 中国微创外科杂志

Objective To evaluate short-term therapeutic effects of laser therapy combined with high ligation of the great saphenous vein in the treatment of varicose veins in the lower extremities. Methods Endovenous laser treatment combined with high ligation of the great saphenous vein was performed on 46 patients with varicose veins in the lower limbs (55 limbs). Results The operation time was 30-65 min (mean, 48 min) for each limb. The number of incisions was 1-5 (mean, 2.8) in each limb. Hospital stay after operation was 3-5 d (mean, 3.6 d). Postoperatively, subcutaneous bleeding occurred in 11 limbs (20%), skin burn was seen in 6 limbs (11%). Among the patients, 42 (50 limbs) were followed up for 2-19 months (mean, 13.5 months), during which no recurrence was found. Conclusion Laser treatment combined with high ligation of the great saphenous vein is effective for varicose veins in the lower extremities.