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Saphenous vein sparing surgery: principles, techniques and results
P Zamboni1, M G Marcellino, M Cappelli
1Institute of General Surgery and Vascular Laboratory, University of Ferrara, Italy.
The Journal of Cardiovascular Surgery
|June 25, 1998
Summary
Saphenous vein sparing surgeries, external valve-plasties (EV-SFJ) and hemodynamic correction (CHIVA), effectively treat varicose veins. These methods preserve veins for potential bypass surgery better than traditional ligation and avulsion.
Area of Science:
- Vascular Surgery
- Phlebology
- Minimally Invasive Procedures
Background:
- Traditional varicose vein treatments like high ligation and avulsion may compromise saphenous vein suitability for future bypass surgery.
- Alternative techniques aim to preserve saphenous vein function and integrity.
Purpose of the Study:
- To evaluate the effectiveness and suitability for bypass surgery of saphenous vein sparing procedures.
- Comparison of external valve-plasties of the sapheno-femoral junction (EV-SFJ) and hemodynamic correction of varicose veins (CHIVA) against traditional methods.
Main Methods:
- Prospective study of 421 varicose vein operations: 64 EV-SFJ and 357 CHIVA.
- Patients selected via clinical and duplex evaluations (CEAP criteria).
- EV-SFJ restores valve function; CHIVA uses selective ligatures to preserve saphenous drainage.
Main Results:
- Overall saphenous vein patency was 94% for both EV-SFJ and CHIVA.
- Varicose vein recurrence rates were 12% (EV-SFJ) and 11% (CHIVA).
- Statistically significant improvement in postoperative AVP and LRR-RT measurements (p<0.001).
Conclusions:
- EV-SFJ and CHIVA are effective treatments for varicose veins based on their indications.
- These sparing techniques preserve a higher rate of saphenous veins suitable for arterial bypass grafting compared to high ligation and avulsion.