Neovascularization in Recurrence of the Varicose Great Saphenous Vein following Transection

Glass, G. M.

doi:10.1177/026835558700200205

Cited by 89 publications

(50 citation statements)

References 19 publications

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“…In cases with increasing severity, surgical revision and antibiotic therapy may also be necessary. 28 Both uncompleted surgery of the SFJ and neovascularization caused by the surgical injury to the venous wall 22,[29][30][31][32][33] are commonly considered to be the main factors responsible for recurrence. Neovascularization seems to be more frequently produced by the transformation of thrombi, healing wounds, and hematomas.…”

Section: Discussionmentioning

confidence: 99%

Duplex ultrasound changes in the great saphenous vein after endosaphenous laser occlusion with 808-nm wavelength

Corcos

Dini

Peruzzi³

et al. 2008

Journal of Vascular Surgery

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The healing process is based on vein thrombosis, fibrosis, and venous atrophy. Saphenofemoral interruption makes venous occlusion easier and prevents potential thrombotic complications and recurrence by recanalization. DUS monitoring makes possible to follow-up the thrombus involution and perform early retreatment. The 808-nm endosaphenous laser should be mainly applied to veins of <10 mm in diameter.

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Section: Discussionmentioning

confidence: 99%

Duplex ultrasound changes in the great saphenous vein after endosaphenous laser occlusion with 808-nm wavelength

Corcos

Dini

Peruzzi³

et al. 2008

Journal of Vascular Surgery

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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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“…45 This phenomenon of formation of new venous channels between the saphenous stump on the common femoral vein (CFV) and the residual GSV or its tributaries is called neovascularization. 46 The potential pathophysiological mechanisms of reference are many: angiogenic stimulation in the free endothelium of the ligated stump, trans-nodal lymphovenous connection, dilation of small adventitial vessels in the vasa vasorum of the femoral vein, disturbed venous drainage of the ligated tributaries of the SFJ.…”

Section: Recurrencesmentioning

confidence: 99%

The sapheno femoral junction involvement in the treatment of varicose veins disease

Ricci¹

2017

Veins and Lymphatics

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Sapheno femoral junction (SFJ) incompetence has been considered the most important cause of chronic venous insufficiency in a high percent of cases since the beginning of history varicose veins treatment. As a consequence SFJ dissection, ligation and section has been practiced all along the last century, generally associated to great saphenous vein stripping, with the porpoise of stopping the effect of hydrostatic pressure considered the origin of varicose veins. Recurrence prevalence at the site of SFJ, even in correctly performed dissection suggests that this attitude may not be the ideal one. Moreover, with the introduction of catheter-based systems of endovenous heating of the great saphenous vein with radiofrequency or endovenous laser ablation, it was shown that venous ablation could be achieved without high ligation of the SFJ. Also foam sclerotherapy demonstrated good results, even if less effective, always leaving the SFJ untouched. Following this trend several methods have been suggested that spare the SFJ, so that this site have lost its strategical importance. In this review history of the SFJ involvement in the varicose vein strategy is analyzed with particular attention to the new generation methods, technology assisted, launched on the market.

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Neovascularization in Recurrence of the Varicose Great Saphenous Vein following Transection

Cited by 89 publications

References 19 publications

Duplex ultrasound changes in the great saphenous vein after endosaphenous laser occlusion with 808-nm wavelength

Duplex ultrasound changes in the great saphenous vein after endosaphenous laser occlusion with 808-nm wavelength

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

The sapheno femoral junction involvement in the treatment of varicose veins disease

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