Phlebologie 2019; 48(03): 147-152
DOI: 10.1055/a-0887-7265
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Extraluminal valvuloplasty of the great saphenous vein: surgical technique and long-term results

Article in several languages: deutsch | English
Bruno Geier
1   Klinik für Gefäßchirurgie und Phlebologie, Bethanien-Krankenhaus Moers
,
Barbara Strohmann
2   Venenzentrum der Gefäßchirurgischen und Dermatologischen Kliniken, St.Josef-Hospital, Klinikum der Ruhr-Universität Bochum
,
Thomas Hummel
2   Venenzentrum der Gefäßchirurgischen und Dermatologischen Kliniken, St.Josef-Hospital, Klinikum der Ruhr-Universität Bochum
,
Harald Freis
1   Klinik für Gefäßchirurgie und Phlebologie, Bethanien-Krankenhaus Moers
,
Markus Stücker
2   Venenzentrum der Gefäßchirurgischen und Dermatologischen Kliniken, St.Josef-Hospital, Klinikum der Ruhr-Universität Bochum
,
Achim Mumme
2   Venenzentrum der Gefäßchirurgischen und Dermatologischen Kliniken, St.Josef-Hospital, Klinikum der Ruhr-Universität Bochum
› Author Affiliations
Further Information

Publication History

27 September 2018

14 March 2019

Publication Date:
02 May 2019 (online)

Abstract

The extraluminal valvuloplasty of the sapheno-femoral junction is a vein-sparing operative technique which can be used in selected patients with incompetence of the greater saphenous vein. The operation can be performed safely and cosmetically favourable through a small groin incision. The follow-up of a group of 43 legs after a mean interval of 8.5 years demonstrated good results in terms of patient satisfaction, relief of symptoms and regression of previously dilated veins. Treatment for recurrent varicose veins was necessary in 10 cases (18,5 %).

Judging from our experience, extraluminal valvuloplasty seems to be a vein-sparing alternative to stripping in selected patients.

 
  • Literatur / References

  • 1 Belcaro G, Nicolaides AN, Errichi BM. et al. Expanded polytetrafluoroethylene in external valvuloplasty for superficial or deep vein incompetence. Angiology 2000; 51: 27-32
  • 2 Chant ABD, Jones HO, Wedell JM. Varicose veins: a comparison of surgery and injection/compression sclerotherapy. Lancet 1972; 2: 1188-1191
  • 3 Corcos L, Peruzzi GP, Romeo V. et al. External valvuloplasty of the sapheno-femoral junction. Phlebologie 1991; 44: 497-508
  • 4 Cox SJ, Wellwood JM, Martin A. Saphenous nerve injury caused by stripping the long saphenous vein. Br Med Journal 1974; 286: 415-417
  • 5 Einarsson E, Ekloff B, Neylen P. Sclerotherapy or surgery as treatment for varicose veins: a prospective randomized study. Phlebology 1993; 8: 22-26
  • 6 Fischer R, Linde N, Duff C. et al. Late recurrent saphenofemoral junction reflux after ligation and stripping of the greater saphenous vein. J Vasc Surg 2001; 34: 236-240
  • 7 Geier B, Voigt I, Marpe B. et al. External valvuloplasty in the treatment of greater saphenous vein insufficiency: a five year follow-up. Phlebology 2003; 18: 137-142
  • 8 Hanrahan LM, Kechejian GJ, Cordts PR. et al. Patterns of venous insufficiency in patients with varicose veins. Arch Surg 1991; 126: 687-690
  • 9 Hach W. Phlebographie der Bein- und Beckenvenen. Konstanz: Schnetztor; 1985
  • 10 Hobbs JT. Surgery and sclerotherapy in the treatment of varicose veins. Arch surg 1974; 190: 793-796
  • 11 Hobbs JT. Surgery or sclerotherapy for varicose veins: 10 year results of a random study. In: Tesi M, Dormandy J. editors Superficial and deep venous diseases of the lower limbs. Turin: Edizione Minerva Medica; 1984: 243-246
  • 12 Ik Kim D, Boong Lee B, Bergan JJ. Venous hemodynamic changes after external banding valvuloplasty with varicosectomy in the treatment of primary varicose veins. J Cardiovasc Surg (Torino) 1999; 40: 567-570
  • 13 Incandela L, Belcaro G, Nicolaides AN. et al. Superficial vein valve repair with a new external valve support (EVS). The IMES (International Multicenter EVS Study). Angiology 2000; 51: 39-52
  • 14 Jacobson HB. The value of different forms of treatment for varicose veins. Br J Surg 1979; 66: 72-76
  • 15 Jessup G, Lane RJ. Repair of incompetent venous valves: a new technique. J Vasc Surg 1988; 8: 569-575
  • 16 Labropoulos N, Giannoukas AD, Delis K. et al. Where does venous reflux start?. J Vasc Surg 1997; 26: 736-742
  • 17 Labropoulos N, Leon M, Nicolaides AN. et al. Superficial venous insufficiency: correlation of anatomic extent of reflux with clinical symptoms and signs. J Vasc Surg 1994; 20: 953-958
  • 18 Lane RJ, Cuzzilla ML, Coroneos JC. The treatment of varicose veins with external stenting to the saphenofemoral junction. Vasc Endovascular Surg 2002; 36: 179-192
  • 19 Lane RJ, Cuzzilla ML, Coroneos JC. et al. Recurrence rates following external valvular stenting of the saphenofemoral junction: a comparison with simultaneous contralateral stripping of the great saphenous vein. Eur J Vasc Endovasc Surg 2007; 34: 595-603
  • 20 Mildner A, Hilbe G. Complications in surgery of varicose veins. Zentralbl Chir 2001; 126: 543-545
  • 21 Mühlberger D, Mumme A, Reich-Schupke S. et al. Extraluminale Valvuloplastie – Indikation und Ergebnisse anhand eines Fallberichtes. Phlebologie 2018; 47 (Suppl. 05) 257-260
  • 22 Mumme A, Stücker M, Hummel T. Die extraluminale Valvuloplastie der Vena saphena magna. Gefäßchirurgie 2014; 19: 637-642
  • 23 Papapostolou G, Altenkämper H, Bernheim C. et al. Die LaVaCro-Studie: Langzeitergebnisse der Varizenoperation mit Crossektomie und Stripping der V. saphena magna. Phlebologie 2013; 42 (Suppl. 05) 253-260
  • 24 Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg 1995; 21: 635-645
  • 25 Recek C. Venous hemodynamics in the legs of healthy human subjects and in primary varicose veins. Phlebologie 2001; 30: 107-114
  • 26 Sakurai T, Gupta PC, Matsushita M. et al. Correlation of the anatomical distribution of venous reflux with clinical symptoms and venous hemodynamics in primary varicose veins. Br J Surg 1998; 85: 213-216
  • 27 Schanzer H, Skladany M. Varicose vein surgery with preservation of the saphenous vein: A comparison between high ligation-avulsion versus saphenofemoral banding-avulsion. J Vasc Surg 1994; 20: 684-687
  • 28 Zamboni P, Marcellino MG, Capelli M. et al. Saphenous vein sparing surgery: principles, techniques and results. J Cardiovasc Surg (Torino) 1998; 39: 151-162