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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Updated: Oct 18, 2025

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Surgery for deep venous insufficiency.

Ravi Raj Goel1, Simon C Hardy1, Tamara Brown2

  • 1Department of Vascular Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital (Trust HQ), Blackburn, UK.

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|September 30, 2021
PubMed
Summary
This summary is machine-generated.

Surgical management for deep venous insufficiency, specifically valvuloplasty, shows limited evidence for effectiveness. More research is needed to determine its impact on ulcer healing and recurrence.

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Area of Science:

  • Vascular Surgery
  • Venous Disease Management
  • Randomized Controlled Trials

Background:

  • Chronic deep venous insufficiency (DVI) stems from valve incompetence or vein blockage, causing ulcers, pain, and swelling.
  • While graduated compression stockings (GCS) and wound care are standard, some patients experience persistent symptoms and recurring ulcers.
  • Surgical interventions for severe DVI are sometimes considered when conservative measures fail.

Purpose of the Study:

  • To evaluate the efficacy of surgical DVI treatments.
  • Assess outcomes including ulcer healing, recurrence, surgical complications, clinical status, quality of life (QoL), and pain.
  • Update previous reviews on surgical DVI management.

Main Methods:

  • Searched multiple databases (Cochrane Vascular, CENTRAL, MEDLINE, Embase, CINAHL) and trial registries up to June 2020.
  • Included randomized controlled trials (RCTs) comparing surgical DVI treatments against other surgical methods, usual care, or no treatment.
  • Assessed trial inclusion, data extraction, risk of bias (Cochrane tool), and evidence certainty (GRADE); data pooling was not feasible due to heterogeneity.

Main Results:

  • Four RCTs (273 participants) on valvuloplasty plus superficial venous surgery for primary valvular incompetence were included; follow-up ranged from 2 to 10 years.
  • No studies reported on ulcer healing or recurrence. Complications, deep vein thrombosis, and deaths were not significantly reported (very low-certainty evidence).
  • Clinical changes were reported variably; some studies indicated potential improvements in CEAP scores and clinical condition with valvuloplasty, but evidence quality was low to very low.

Conclusions:

  • The current evidence base for surgical DVI treatment is limited to four RCTs on valvuloplasty for primary valve incompetence.
  • No studies addressed other surgical procedures, secondary DVI, or venous obstruction.
  • Due to insufficient data and low-certainty evidence regarding ulcer healing, recurrence, and clinical outcomes, definitive conclusions on the effectiveness of valvuloplasty for DVI cannot be drawn.