Where does venous reflux start?

Labropoulos, Nicos; Giannoukas, Athanasios D.; Delis, Konstantinos T.; Mansour, M. Ashraf; Kang, Seung-Min; Nicolaides, Andrew; Lumley, J. S. P.; Baker, William H.

doi:10.1016/s0741-5214(97)70084-3

Cited by 252 publications

(198 citation statements)

References 47 publications

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“…This may result in a localized cluster of dilated veins that ascends up the leg. 33 In addition, reflux may also occur in venous tributaries in the absence of any truncal superficial or deep vein or perforator vein reflux. 34 The most common tributaries with reflux are in communication with the GSV (≈60%), small saphenous vein (≈20%), or both (≈10%).…”

Section: Venous Pathophysiology and Dysfunctionmentioning

confidence: 99%

Chronic Venous Insufficiency

2014

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Section: Venous Pathophysiology and Dysfunctionmentioning

confidence: 99%

Chronic Venous Insufficiency

2014

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“…Indeed, the reversibility of the GSV reflux was reported by Quill and Fegan (24) long time ago following compression sclerotherapy. In addition to these studies, several publications have challenged the theory of descending progression, citing the possibility of local or multifocal early distal evolution (ascending) based on detailed duplex scanning (1)(2)(3)(4)(5). A recent report based on 2,275 duplex scanning results showed reflux that appeared to progress in an ascending manner from the superficial tributaries to the SV and then to the SFJ (5).…”

Section: Discussionmentioning

confidence: 99%

The endovenous ASVAL method: principles and preliminary results

Atasoy

Oğuzkurt²

2015

Diagn Interv Radiol

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A mbulatory selective varicose vein ablation under local anesthesia (ASVAL) is a surgical treatment for varicose veins based on the ascending hypothesis that venous insufficiency progresses in an ascending manner, from the superficial tributaries to the saphenous vein (SV) and then to the sapheno-femoral junction (SFJ). Recent scientific data based on precise and detailed duplex scanning support this hypothesis (1-6). The ASVAL method recommends preserving the great saphenous vein (GSV), unless there is a serious terminal valve insufficiency, and suggests the surgical removal (phlebectomy) of the superficial varicose reservoir (SVR) as a primary treatment. The major argument in favor of preserving the GSV is the essential physiologic role that the GSV could play in superficial drainage and, to a lesser extent, its availability as revascularization material. Although the original ASVAL method is performed using simple phlebectomies, many patients refuse to have this treatment because they regard it as a surgical operation that would likely yield poor cosmetic results. Thermal endovenous techniques and foam sclerotherapy are less aggressive and are reported to be as effective as traditional surgical treatments (7). The question arises as to whether the ASVAL approach can be performed using endovenous techniques. To the best of our knowledge, this research will be a preliminary study describing the endovenous technique for the ASVAL approach.The purpose of this study was to investigate the feasibility and safety of endovenous ASVAL (eASVAL) technique and to present the short-term results with one-year ultrasonography (US) follow-up in a selected group of patients. PURPOSEWe aimed to investigate the feasibility and safety of the endovenous ambulatory selective varicose vein ablation under local anesthesia (eASVAL) method in a selected group of pa tients with varicose disease and present the short-term results of one-year ultrasonographic follow-up. METHODSThree hundred and ninety-five consecutive patients with varicose veins who had been treated with endovenous laser ablation (EVLA) were retrospectively reviewed over a period of two years. From this group, 41 patients who were treated using the eASVAL technique and had the great saphenous vein (GSV) preserved were included in the study. These patients had only limited segmental GSV reflux accompanied by a competent terminal valve. The eASVAL technique can be defined as EVLA of the proximal straight segments of the major tributaries connecting the symptomatic varicose veins with the GSV, followed by ultrasound-guided foam sclerotherapy of the superficial varicose veins themselves. The patients were assessed before and after the treatment by duplex scan findings and clinical assessment scores. RESULTSThe GSVs were successfully preserved in all 41 cases, and all patients showed significant clinical improvement using the eASVAL approach (P < 0.001). Segmental reflux was no longer present in 75.3% of patients. The mean diameters of the GSVs were significantly reduced at...

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“…Though etiology can be multifactorial, the origin of venous reflux in primary varicose veins can be local or multifocal structural weakness of the vein wall and that can occur together or independently of proximal saphenous incompetence. [5] Varicosities can be seen in the great or short saphenous vein territory or any subcutaneous vein in the lower limb. Patients with varicose veins may present with no symptoms at all.…”

Section: Discussionmentioning

confidence: 99%