Common peroneal nerve injury as a complication of short saphenous vein surgery

Atkin, Gary; Round, T; Vattipally, Vikram; Das, Saroj

doi:10.1258/026835507779700653

Cited by 21 publications

(14 citation statements)

References 13 publications

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“…4 Perioperative complication rates were low in the present series, as in other reports. 12 There were no major adverse events, and specifically no recorded DVTs; the only one significant (sural) nerve injury resolved completely. Some aspects of the results suggest that there is potential for recurrence in the future.…”

Section: Discussionmentioning

confidence: 81%

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

O’Hare

Vandenbroeck

Whitman

et al. 2008

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 81%

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

O’Hare

Vandenbroeck

Whitman

et al. 2008

Journal of Vascular Surgery

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“…Common peroneal nerve injury occurred in 4.7% in one series and in 6.7% in another series in those patients who underwent SSV ligation or stripping. 207 Injury to the femoral artery and vein. Injury to the femoral vein or artery during high ligation of the saphenous vein is, fortunately, very rare.…”

Section: Results Of Open Venous Surgerymentioning

confidence: 99%

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,293

952

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The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping of the saphenous vein to the level of the knee (GRADE 1B). We recommend phlebectomy or sclerotherapy to treat varicose tributaries (GRADE 1B) and suggest foam sclerotherapy as an option for the treatment of the incompetent saphenous vein (GRADE 2C). We recommend against selective treatment of perforating vein incompetence in patients with simple varicose veins (CEAP class C(2); GRADE 1B), but we suggest treatment of pathologic perforating veins (outward flow duration ≥500 ms, vein diameter ≥3.5 mm) located underneath healed or active ulcers (CEAP class C(5)-C(6); GRADE 2B). We suggest treatment of pelvic congestion syndrome and pelvic varices with coil embolization, plugs, or transcatheter sclerotherapy, used alone or together (GRADE 2B).

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“…The rate of CPN injury is reported to be as high as 2 -4% in some series. 46,47 This significant nerve injury results in foot drop. It is often said to occur from forceful use of the phlebectomy hook close to the neck of the fibula, but an assessment of medicolegal claims after varicose vein surgery showed that 17/18 CPN injuries occurred during dissection in the popliteal fossa.…”

Section: Nerve Injurymentioning

confidence: 99%

Standard varicose vein surgery

Perkins

2009

Phlebology

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This article examines the practice of standard varicose vein surgery including sapheno-femoral and sapheno-popliteal ligation, perforator surgery and surgery for recurrent varicose veins. The technique of exposure of the sapheno-femoral junction and the sapheno-popliteal junction is outlined and advice given on avoidance of complications for both. The evidence regarding methods of closure over the ligated sapheno-femoral junction is examined as is the requirement for stripping and the use of different types of stripper. The requirement to strip the small saphenous vein and the extent of dissection necessary in the popliteal fossa is also examined. Complications of standard varicose vein surgery are outlined. The frequency of wound infection, nerve injury, vascular injury and venous thromboembolism are listed and strategies to avoid these complications are examined.

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Common peroneal nerve injury as a complication of short saphenous vein surgery

Abstract: CPN injury during SSV surgery occurs with an appreciable frequency. In view of this, there is a need for a revised approach to the management of SSV disease, possibly incorporating less-invasive techniques such as endovenous closure.

Cited by 21 publications

References 13 publications

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Standard varicose vein surgery

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