A Clinical Analysis of the Treatment of Primary Varicose Vein of the Lower Limbs

BACKGROUND: Primary varicose veins are caused by a retrograde blood flow and increased hydrostatic pressure as a result of an increase in height or in physical strain associated with work. Treatment for varicose vein involves 1) conservative management - periodic leg elevation, elastic stocking support, and exercise with stocking support, 2) sclerotherapy, and 3) surgery. METHODS: Ninety-two limbs with primary varicose veins of the lower limb were operated on from Jan. 1996 to Dec. 1996. RESULTS: The prevalent age group consisted of those patients between 50 and 60 years old, and the female to male ratio was 2 : 1. Varicose veins developed in the right lower limb in 48 cases, in the left lower limb in 37 cases, and in both lower limbs in 7 cases. Presumed etiological factors included occupations requiring long periods of standing in 13 male cases, and pregnancy in 26 female cases. The average duration of illness was 12.5 8.6 years. Of the 92 cases operated on, a greater saphenous vein (GSV) high ligation (HL) and above knee (AK) stripping with varicosectomy (VS) was done in 38 cases, a GSV HL and total stripping with VS in 4 cases, a short saphenous vein (SSV) HL and VS in 14 cases, an external banding valvuloplasty of GSV and VS in 29 cases, an external banding valvuloplasty only in 2 cases, a Linton's operation in 2 cases, a GSV branch ligation and VS in 1 case, and sclerotherapy in 2 cases. The reduction rates of venous volume (VV) and ambulatory venous pressure (AVP) were 15 19% and 33 33%, respectively, after stripping. The reduction rates of VV and AVP were 19 18% and 33 36%, respectively, after valvuloplasty. Postoperative complications were wound complication in 1 case in the AK stripping group; postoperative numbness in 3 cases and wound complication in 1 case in the total stripping group; and wound complication in 1 case, GSV thrombosis in 2 cases, postoperative bleeding in 1 case, and postoperative reflux in 1 case in the valvuloplasty group. CONCLUSIONS: Generally, postoperative conditions were good and complications were negligible. In the stripping group, postoperative numbness developed only in the total stripping group. Between the valvuloplasty and the stripping groups, there was no significant hemodynamic difference.

Characteristics of Vascular Anatomy and Hemodynamics in Korean Population

The value of the noninvasive diagnostic methods for vascular disease is worthy of emphasis. In many studies, the diagnostic abnormal findings of the vascular disease were reported. But there were a few studies for normal human vasculatures measuring with noninvasive diagnostic methods. And more, there is few data for vasculature of Oriental people, especially of the Korean population. The authors examed 20 healthy persons without any vascular disease by using the noninvasive vascular diagnostic tool-duplex scan and air plethysmography. The knowledge of the normal data of human vasculature, especially Korean population, will improve the sensitivity and specificity of the noninvasive vascular diagnostic methods. It is not appropriate to presume that this report with analysis of only 20 cases represent the normal data of Korean population. Further collection of the data is needed to define the normal data of vasculature of Korean population.