Changes in Venous Hemodynamics after Superficial Vein Surgery for Mixed Superficial and Deep Venous Insufficiency

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• 作者：Albert C.W. Ting ; Stephen W.K. Cheng ; Lisa L.H. WuR.V.T. and Grace C.Y. CheungB.Sc.
• 刊名：World Journal of Surgery
• 出版年：2001
• 出版时间：February 2001
• 年：2001
• 卷：25
• 期：2
• 页码：122-125
• 全文大小：82 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Cardiac Surgery
  General Surgery
  Thoracic Surgery
  Vascular Surgery
  
• 出版者：Springer New York
• ISSN：1432-2323

文摘

The purpose of this study was to determine the hemodynamic changes after superficial vein surgery in patients with mixed superficial and deep venous insufficiency (MVI). Between July 1996 and June 1998, all patients with MVI together with saphenofemoral reflux were evaluated prospectively with air plethysmography (APG) and duplex scanning before and 1 month after superficial vein surgery. Saphenofemoral flush ligation without stripping was performed with multiple small incisions for avulsion of varicosities. Seventy-eight patients with 102 operated limbs were included for analysis. The venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) improved significantly after superficial vein surgery (mean VFI 5.99 ± 3.39 vs. 1.82 ± 1.21 ml/s, p < 0.001; mean EF 48.39% ± 11.74% vs. 52.78% ± 14.33%, p < 0.05; mean RVF 49.80% ± 11.18% vs. 36.19% ± 12.98%, p < 0.001, respectively, before and after operation). The proportion of limbs with deep venous incompetence on duplex scanning at more than one site decreased from 70% to 44% after operation. The mean number of sites with deep venous incompetence decreased from 2.14 ± 0.96 to 1.52 ± 1.21 after operation (p < 0.001). In conclusion, superficial vein surgery resulted in significant improvement in hemodynamic parameters in limbs with MVI. There was also abolition of deep venous reflux after superficial vein surgery alone. Superficial vein surgery should be the first line of treatment in limbs with MVI, with deep vein reconstructive surgery reserved for those not responding to superficial vein surgery.