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Phlebosclerosis in lower extremities veins - a systematic review
Kostas Tepelenis1, Georgios Papathanakos2, Alexandra Barbouti3
1Department of Surgery, General Hospital of Filiates, Thesprotia, Greece.
VASA. Zeitschrift Fur Gefasskrankheiten
|April 24, 2020
Summary
Phlebosclerosis, a venous wall disease, is most common in the small saphenous vein. Its presence in great saphenous vein grafts may negatively impact bypass surgery outcomes.
Area of Science:
- Vascular Biology
- Venous Disease Epidemiology
- Surgical Outcomes
Background:
- Phlebosclerosis is an under-recognized venous wall degenerative condition.
- Its clinical significance, particularly in lower extremity veins, remains unclear.
- Understanding phlebosclerosis is crucial for evaluating vein graft patency.
Purpose of the Study:
- To review the epidemiology, etiology, and clinical significance of phlebosclerosis in lower extremity veins.
- To assess the impact of great saphenous vein phlebosclerosis on vein graft patency.
- To identify risk factors associated with phlebosclerosis.
Main Methods:
- Systematic review of Medline and reference lists (inception–November 2019).
- Inclusion of studies published after 1949.
- Data extraction from 16 cohort and 1 case-control study (3708 participants).
Main Results:
- Radiological incidence of phlebosclerosis: 1.5–9.7%.
- Histological incidence in great saphenous vein grafts: 26.9–91%.
- Small saphenous vein is the most commonly affected, followed by the great saphenous vein.
- Associated with age, venous insufficiency, and hemodialysis.
- Seven studies show a correlation between phlebosclerosis and vein graft stenosis; three did not.
Conclusions:
- Phlebosclerosis incidence varies based on diagnostic method (radiological vs. histological).
- The small saphenous vein is predominantly affected.
- Age, hemodialysis, and venous insufficiency are key risk factors.
- Preexisting phlebosclerosis in great saphenous vein grafts may impair bypass surgery patency.
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