Ligation of the saphenofemoral junction tributaries as risk factor for groin recurrence

Cappelli, Massimo; Molino-Lova, Raffaele; Giangrandi, Ilaria; Ermini, Stefano; Gianesini, Sergio

doi:10.1016/j.jvsv.2017.09.005

Cited by 21 publications

(27 citation statements)

References 12 publications

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“…Clinical studies support the view that ligation of all junctional saphenous tributaries is associated with a higher risk of varicose vein recurrence. 7 These data suggest that an approach with less resection may help reduce recurrence.…”

Section: Discussionmentioning

confidence: 93%

CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report

et al. 2019

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CHIVA (Cure Conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire) is a type of operation for varicose veins that avoids destroying the saphenous vein and collaterals. We report a case of CHIVA treatment of two saphenous veins to spare these veins. The patient previously had a normal great saphenous vein stripped in error in a wrong-site surgery, while two saphenous veins that did have reflux were not operated. The patient was symptomatic and we performed a CHIVA operation on the left great and right small saphenous veins. The postoperative period was uneventful and both aesthetic and clinical results were satisfactory. This case illustrates that saphenous-sparing procedures can play an important role in treatment of chronic venous insufficiency. Additionally, most safe surgery protocols do not adequately cover varicose veins operations. Routine use of duplex scanning by the surgical team could prevent problems related to the operation site.

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Section: Discussionmentioning

confidence: 93%

CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report

et al. 2019

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“…The question of whether removal of GSV tributary veins is necessary to prevent recurrence was also recently addressed [10]. Patients had high ligation either alone or with ligation of SFJ tributaries.…”

Section: Technical Improvements To Endovenous and Surgical Proceduresmentioning

confidence: 99%

Advanced Stages of Chronic Venous Disease: Evolution of Surgical Techniques and Advantages of Associated Medical Treatment

Lurie¹

2020

Adv Ther

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Contemporary interventional treatment of primary chronic venous disease (CVD) is mainly focused on the treatment of venous reflux. The long-term results of endovenous ablation (EVA) and high ligation and stripping are not different with respect to varicose vein recurrence, and this recurrence appears to be a manifestation of disease progression. Since inflammation is one of the key mechanisms of CVD development and progression, efforts to minimize inflammation and angiogenic potential in endovenous and surgical procedures are worthwhile. As techniques continue to be refined, surgery remains a valid option; in particular, the techniques that minimize trauma can be beneficial regarding recurrence. Medical treatment with venoactive drug therapy such as micronized purified flavonoid fraction (MPFF; Daflon Ò), which has proven clinical benefits in patients with CVD, can be used before and after EVA or surgery to minimize inflammation, pain, hemorrhage, and reduce CVD symptoms.

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“…Der Ausgangspunkt für die Ausbildung einer Neo-Saphena könnte das freiliegende Endothel des Krossenstumpfes oder eines Seitenastes sein, das nach Krossektomie durch Kontakt mit dem umliegenden Subkutangewebe die Neo-Angiogenese stimuliert. Cappelli, Molino-Lova, Giangrandi et al [16] beschrieben, dass sogar die Ligation der Seitenäste mit einem signifikant höheren Rezidivrisiko verbunden ist.…”

Section: Neo-saphenaunclassified

Saphenofemoral recurrence from an an anatomist’s point of view

Brenner

2020

Phlebologie

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From an anatomical point of view, recurrences at the saphenofemoral junction (SFJ) could result from various sources. For one, it could be caused by a recanalisation of an originally occluded great saphenous vein (GSV). Secondly, another vein in the junction region could take over the function of the GSV and dilate. A third variation is a – more or less successful – generation of a new vein. In the last case, a sufficient vein could be generated, an insufficient vein could arise, or an inadequate venous regeneration, so that a cluster of frail but incomplete vasculature remains (neovasculature).

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Ligation of the saphenofemoral junction tributaries as risk factor for groin recurrence

Cited by 21 publications

References 12 publications

CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report

CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report

Advanced Stages of Chronic Venous Disease: Evolution of Surgical Techniques and Advantages of Associated Medical Treatment

Saphenofemoral recurrence from an an anatomist’s point of view

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