Chronic Venous Insufficiency and Options for Modern Surgical Treatment within the Superficial System
Authors:
J. Marušiak
Authors‘ workplace:
Oddělení cévní a rekonstrukční chirurgie, Krajská nemocnice Liberec a. s., primář MUDr. J. Marušiak, Ph. D.
Published in:
Rozhl. Chir., 2010, roč. 89, č. 1, s. 73-79.
Category:
Monothematic special - Original
Overview
The author describes his experience with the therapy of CVI and informs about the present state of the surgical knowledge about this topic. The classification is based on the last recommendations from Roma (2000, modified CEAP). The surgical therapy of CVI the author has divided into surgery of superficial venous system, surgical therapy of perforators and possibilities of surgical approach in the therapy of deep veins pathology (reflux and obstruction). He emphasizes complex therapy in case of each patient and recommends the use of compressive and medical therapy as permanent and all the life lasting method as the best strategy in this group of patients.
Chronic venous insuficiency with its typical several stadium of varicose veins is presently cured with different kinds of surgical therapy. There is growing interest in developing minimally invasive or endovascular techniques for the treatment of varicose veins. The author describes these modern methods and experience from his praxis.
Key words:
chronic venous insuficiency – surgical therapy
Sources
1. Callam, M. J., Ruckley, C. V., Harper, D. R., Dále, J. J. Chronic ulceration of the leg: extent of the problem and provision of care. BMJ, 1985, 290: 1855–1856.
2. Coleridge Smith, P. D. Venous ulcer. Br. J. Surg., 1994, 81: 1404–1405.
3. Spáčil, J. Péče o chronické poruchy žil dolních končetin: zpráva mezinárodní komise založená na důkazech. Prakt. flebol., 9, 2000, č. 4: 161–165.
4. Homans J. The etiology and treatment of varicose ulcer of the leg. Surg. Gynecol. Obstet., 1917, 24: 300–311.
5. Schmeller, W., Roszinski, S., Tronnier, M., Gmelin, E. Combined morphological and physiological examinations in lipodermatosclerosis. In: Raymond-Martimbeau P, Prescott R, Zummo M, eds. Phlebologie 92. Paris: John Libbey Eurotext, 1992: 172–174.
6. Landis, E. M. Microinjection studies of capillary blood pressure in human skin. Heart.1930,15: 209–228.
7. Junger, M., Hahn, M., Klyscz, T., Steins, A. Role of microangiopathy in the development of venous leg ulcer. Prog. Appl. Microcirc., 1999, 23: 180–193.
8. Bergan, J. J. Application of microcirculatory principles in the treatment of chronic venous insufficiency. Microcirculation. 1999, 23: 194–206.
9. Takase, S., Lerond, L., Bergan, J. J., Schmid-Schonbein, G. W. The inflamatory reaction during venous hypertension in the rat. Microcirculation, 2000, 7: 41–52.
10. van Bemmelen, S. P., Hoynck van Papendrecht, A. A., Hodde, K. C., Klopper, P. J. A study of valve incompetence that developed in an experimental model of venous hypertension. Arch. Surg., 1986, 121: 1048–1052.
11. Hahn, T. L., Unthank, J. L., Lalka, S. G. Increased hindlimb leukocyte concentration in a chronic rodent model of venous hypertension. J. Surg. Res., 1999, 81: 38–41.
12. Takase, S., Delano, F., Lerond, L., Bergan, J. J., Schmid-Schonbein, G. W. Inflammation in CVI: is the problem insurmountable? J. Vasc. Res., 1999, 38 (suppl 1): 3–10.
13. Shields, D. White cell activation. In: Coleridge Smith PD, ed. Microcirculation in Venous Desease. RL Landes Co, 1994, 129–143.
14. Coleridge Smith, P. D. Neutrophil activation and mediators of inflammation in CVI. J. Vasc. Res., 1999, 36: 24–36.
15. Goldman, M. P. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatol. Surg., 2000, 26: 452–456.
16. Boné, C. Tratamiento endoluminal de las varices cpn laser de dio. Studio preliminary. Rev. Patol. BASF, 1999, 5: 35–46.
17. Navarro, L., Min, R. J., Boné, C. Endovenous laser: a new minimally invasive method of treatment for varicose veins – preliminary observations usány an 810 nm diode laser. Dermatol. Surg., 2001, 27: 117–122.
18. Roth, S. M. Endovenous radiofrequency ablation of superficial and perforator veins. Surg. Clin. North. Am., 2007, 87: 1267–1284, xii.
19. Nicolaides, A. N., Zukowski, A. J. The value of dynamic venous pressure measurements. World J. Surg., 10: 919, 1986.
20. Raju, S., Frederick, R. Valve reconstruction procedures for non-obstructive venous insuficiency: Rationale, techniques and results in 107 procedures with 2–8 year follow-up. J. Vasc. Surg., 7: 301, 1988.
21. Kistner, R. L. Reflux desease: Valvuloplasty, transposition, valve transplant. Proc. Straub Pacific Health Found, 57: 37, 1993.
22. Palma, E. C., Esperon, R. Vein transplants and grafts in the surgical treatment of the post-phlebitic syndrom. J. Cardiovasc. Surg., 1: 94, 196.
23. Palma, E. C., Riss, R., DelCampo, F., Tobler, H. Tratamiento de los trastornos post-flebiticos mediante anastomosis venosa safen-femoral contralateral. Sociedad de Cirurgia de Uruguay, 25 Junio, 1958.
24. Dále, W. A., Harris, J. Cross-over vein grafts for iliac and femoral venous occlusion. Ann. Surg., 168: 319, 1968.
25. Dále, W. A. Reconstructive venous surgery. Arch. Surg., 114: 1312, 1979.
26. Warren, R., Thayer, T. R. Transplantation of the saphenous vein for postphlebitic stasis. Surgery, 35: 867, 1954.
27. Husni, E. A. In situ saphenopopliteal bypass graft for incompetence of the femoral and popliteal veins. Surg. Gynecol. Obstet, 130: 279, 1970.
28. Cockett, F. B., Thomas, M. L. The iliac compression syndrom. Br. J. Surg., 52: 816, 1965.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
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