Does venous function deteriorate in patients waiting for varicose vein surgery?

Area of Science:

• Vascular Surgery
• Phlebology
• Patient Outcomes

Background:

• Varicose veins are a common condition affecting lower limbs.
• Long waiting times for surgery may impact disease progression.
• Assessing deterioration during the waiting period is crucial for patient management.

Purpose of the Study:

• To evaluate the clinical and hemodynamic deterioration of lower limbs in patients awaiting varicose vein surgery.
• To quantify the progression of venous reflux and associated conditions during the waiting period.
• To assess the impact of waiting times on surgical planning and potential need for re-operation.

Main Methods:

• Clinical examination of lower limbs.
• Color Duplex scanning to assess venous reflux.
• Photoplethysmography to measure 95% refilling times.
• Prospective evaluation of 36 patients with a median waiting time of 20 months.

Main Results:

• Significant deterioration observed in lower limbs during the waiting period.
• Four initially unaffected limbs developed reflux; three had clinical varicose veins.
• 18% of initially affected limbs showed new sources of reflux, altering planned surgery.
• One new case of lipodermatosclerosis developed; no deep venous insufficiency or ulceration occurred.

Conclusions:

• Extended waiting times for varicose vein surgery are associated with significant lower limb deterioration.
• Deterioration can necessitate changes in surgical plans and potentially lead to increased complexity.
• While severe complications like ulceration were not observed, the impact on patient suffering and quality of life warrants consideration.