Closure of the Cribriform Fascia: An Efficient Anatomical Barrier Against Postoperative Neovascularisation at the Saphenofemoral Junction? A Prospective Study

Maeseneer, M. De; Philipsen, Tine; Vandenbroeck, C.P.; Lauwers, Patrick; Hendriks, Jeroen; Hert, Stefan De; Schil, Paul E. Van

doi:10.1016/j.ejvs.2007.03.020

Cited by 42 publications

(29 citation statements)

References 28 publications

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“…After 1 year, duplex scan showed neovascularization in 15 of 223 limbs (6.7 %). The results were found to be comparable to the group of 191 limbs with silicone patch saphenoplasty and were superior to the group of 189 limbs without barrier [19].…”

Section: Discussionsupporting

confidence: 60%

Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins

et al. 2014

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Varicose veins have a high recurrence rate following surgery. Besides poor surgical technique, majority of these recurrences are attributable to neovascularization after both primary and repeat surgery. Authors have studied the effectiveness of a polytetrafluoroethylene (PTFE) patch interposition between the ligated vein stump and the overlying soft tissue at saphenofemoral junction in decreasing recurrence of varicose veins after initial surgery. Study was conducted on 50 patients of varicose veins with saphenofemoral junction incompetence. Patients were randomly divided into two groups, group A and group B alternately. In group A, standard surgical procedure was done followed by PTFE patch application. In group B, same surgical procedure was applied as in group A, with the exception of PTFE patch application. Patients in both groups were given similar postoperative care. A full venous duplex ultrasound assessment was performed in all the patients postoperatively. Neovascularization was observed in five patients (20 %) of group B, while it was not seen in any of the patients in group A at 1-year follow-up. This difference in neovascularization across the two groups was found to be statistically significant with a p value of 0.0251. Hence, authors concluded that patch saphenoplasty helps in reducing recurrence in varicose veins by decreasing neovascularization at saphenofemoral junction.

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Section: Discussionsupporting

confidence: 60%

Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins

et al. 2014

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“…[3][4][5][6][7] Thus, the inconsistency noted above might be explained by the hypothesis that performing SFJ ligation not only leads to less incompetent groin tributaries but also augments neovascularization in the groin.…”

Section: S Uperficial Venous Insufficiency Is a Common Medicalmentioning

confidence: 99%

Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients

Izumi¹,

Ikeda

Yamashita

et al. 2016

Int. Heart J.

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SummaryEndovenous laser ablation (EVLA), which is a relatively new therapeutic option for saphenous varicose veins of the legs, is less invasive than conventional stripping surgery with ligation. In this study, we evaluated the safety and effectiveness of EVLA combined with ligation for severe saphenous varicose veins that were graded as ≥ C 4 by the CEAP classification. We treated 119 Japanese patients (141 limbs) between July 2005 and December 2007 utilizing a 1320-nm Nd:YAG laser. The obliteration rate of the treated veins was found to be 100% over the entire follow-up period (2.5 years). Consistent with this finding, all of the patients exhibited improved skin lesions (ie, skin pigmentation and ulceration). No major complications, including deep vein thrombosis (DVT) and nerve injury, were observed. A questionnaire survey with a reasonable response rate (66.4%) demonstrated that subjective symptoms and minor complications that were initially observed after EVLA, such as mild pain, numbness, indurations, and localized hot flashes, were remarkably improved by the end of the follow-up period. Furthermore, high levels of patient satisfaction were noted. Thus, EVLA combined with ligation constituted a safe and effective strategy for treating severe saphenous varicose veins in Japanese patients. (Int Heart J 2016; 57: 87-90) Key words: 1320-nm Nd:YAG laser, Skin lesions, High patient satisfaction S uperficial venous insufficiency is a common medical condition that increases with age. Although stripping surgery with high ligation of the saphenofemoral junction (SFJ ligation) has been the standard treatment for great saphenous varicose veins with reflux, several effective alternatives are currently available.Endovenous laser ablation (EVLA) is a minimally invasive technique that has become a common alternative in Japan. EVLA can be performed either with or without SFJ ligation, and controversy persists regarding whether performing SFJ ligation prior to EVLA is truly beneficial for decreasing the recurrence rate of varicose veins. Recent studies have demonstrated that EVLA with SFJ ligation results in less incompetent groin tributaries and less common recanalization after the procedure.1) Interestingly, however, the overall recurrence rate was not improved by performing SFJ ligation.1) This finding was inconsistent with a previous finding that the presence of incompetent groin tributaries contributed to the pathogenesis of recurrent varicosities.2) Neovascularization in the groin is one of the operative stress responses to the SFJ ligation procedure, and it acts as another principal cause of recurrence.3-7) Thus, the inconsistency noted above might be explained by the hypothesis that performing SFJ ligation not only leads to less incompetent groin tributaries but also augments neovascularization in the groin.EVLA is a relatively new technique, and it tends to be applied for mild varicose veins that have been evaluated as class C 2 or C 3 according to the CEAP classification. Therefore, although EVLA has been perfo...

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“…In the mean while, numerous methods to prevent neovascularization have been studied in RCT's. Saphenofemoral patch interposition did not prevent it, but showed a much lower incidence of neovascularization on duplex scan than the above mentioned case controlled study (15 out of 223 ; only 4.5% had symptoms) (9). In a very recent, small in-patient bilateral RCT, laser was performed with high ligation in one leg of patients, and laser without high ligation in the other.…”

Section: Neovascularizationmentioning

confidence: 66%

Endovenous or Open Venous Surgery: Choices to Make

Broek

2008

Acta Chirurgica Belgica

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Closure of the Cribriform Fascia: An Efficient Anatomical Barrier Against Postoperative Neovascularisation at the Saphenofemoral Junction? A Prospective Study

Cited by 42 publications

References 28 publications

Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins

Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins

Safety and Effectiveness of Endovenous Laser Ablation Combined With Ligation for Severe Saphenous Varicose Veins in Japanese Patients

Endovenous or Open Venous Surgery: Choices to Make

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