Phlebologie 2019; 48(03): 170-175
DOI: 10.1055/a-0887-6161
Review
Georg Thieme Verlag KG Stuttgart · New York

Varicose vein surgery: more complications than other procedures?

Article in several languages: deutsch | English
Guido Brunig
Krankenhaus Tabea GmbH & Co. KG im Artemed-Klinikverbund, Hamburg
,
Johanna Buhr
Krankenhaus Tabea GmbH & Co. KG im Artemed-Klinikverbund, Hamburg
› Author Affiliations
Further Information

Publication History

18 September 2018

14 March 2019

Publication Date:
10 May 2019 (online)

Abstract

All methods used in varicose vein therapy go along with a certain amount of risk. Varicose vein surgery is widely spread, and the health risks are described at great length in literature.

Referring to the health risks of new methods such as endovenous therapy or foam sclerotherapy one can barely find any reliably facts and figures.

Overall, varicose vein surgery including crossectomy, stripping and phlebectomy is accompanied with a higher risk of bleeding and postinterventional infection. Generally, these risks are estimated to be marginal.

The risk of perioperative nerve injury appears to be similar in both therapeutic methods. Yet the poor amount of available data regarding endovenous therapy has to be pointed out.

The risk of postoperative thrombosis and pulmonary embolism as well as cosmetically affecting proinflammatory hyperpigmentation appear more often after endovenous therapy and foam sclerotherapy than in varicose vein surgery.

Complications, such as stripping of the deeper great vein or artery during varicose vein surgery or recovered broken metal parts in the vena cava after endovenous therapy are extremely rare events.

Nevertheless, current metanalysis rarely describe any disparity concerning mobility, mortality and health-related quality of life by comparison to the various varicose vein therapies.

 
  • Literatur / References

  • 1 Brittenden J, Cotton SC, Elders A. et al. A Randomized Trial Comparing Treatments for Varicose Veins. New England Journal of Medicine 2014; 371 (13) 1218-1227
  • 2 Faubel IS R, Augustin M, Bruning G. Langzeitergebnisse und Analysen von Zusammenhängen 5 Jahre nach Varizenstripping. Phlebologie 2010; 5: 263-269
  • 3 Ramlet AA. Phelbologie Leitfaden für die Praxis. 1992: 404
  • 4 Rafi-Reichrath L, Stenger D, Nestoris S. et al. Bewährtes und Neues in der diagnostischen/operativen Phlebologie. Aktuelle Dermatologie 2005; 31 (11) 500-503
  • 5 Rudström H, Björck M, Bergqvist D. Iatrogenic Vascular Injuries in Varicose Vein Surgery: a Systematic Review. World Journal of Surgery 2007; 31: 228-233
  • 6 Casian D. Vascular trauma during sugery for varocise veins of lower limbs. Archives of the Balkan Medical Union 2013; 48: 31-33
  • 7 Barker T, Evison F, Benson R. et al. Risk of venous thromboembolism following surgical treatment of superficial venous incompetence. VASA Zeitschrift fur Gefasskrankheiten 2017; 46 (06) 484-489
  • 8 Muleledhu AL, Galukande M, Makobore P. et al. Deep venous thrombosis after major abdominal surgery in a Ugandan hospital: a prospective study. International Journal of Emergency Medicine 2013; 6: 43
  • 9 Smith BR, Diniz S, Stamos M. et al. Deep venous thrombosis after general surgical operations at a university hospital: two-year data from the ACS NSQIP. Archives of surgery (Chicago. Ill : 1960) 2011; 146 (12) 1424-1427
  • 10 Kwak JH, Min SI, Kim S-Y. et al. Delayed Presentation of Endovenous Heat-Induced Thrombosis Treated by Thrombolysis and Subsequent Open Thrombectomy. Vascular Specialist International 2016; 32 (02) 72-76
  • 11 Sufian S, Arnez A, Labropoulos N. et al. Endovenous heat-induced thrombosis after ablation with 1470 nm laser: Incidence, progression, and risk factors. Phlebology 2015; 30 (05) 325-330
  • 12 Fokin AA, Borsuk DA, Kazachkov EL. Efficacy of using rivaroxaban for treatment of heat-induced thrombosis after endovenous laser ablation. Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery 2016; 22 (04) 97-101
  • 13 Poder TG, Fisette JF, Bedard SK. et al. Is radiofrequency ablation of varicose veins a valuable option? A systematic review of the literature with a cost analysis. Canadian journal of surgery Journal canadien de chirurgie 2018; 61 (02) 128-138
  • 14 Cavezzi A, Parsi K. Complications of foam sclerotherapy. Phlebology 2012; 27 (01) 46-51
  • 15 Hill H, Chick JFB, Hage A. et al. N-butyl cyanoacrylate embolotherapy: techniques, complications, and management. Diagnostic and Interventional Radiology 2018; 24 (02) 98-103
  • 16 Bruning G, Buhr JK, Donath M. Varizenchirurgie bei Adipositas. Phelbologie 2018; 47 (02) 71-74
  • 17 Bruning G, Schinagl H. Die operative Sanierung des inguinalen Crossenrezidivs mittels modifiziertem Zugang nach Junod. Journal Der Deutschen Dermatologischen Gesellschaft 2011; 8: 646-649
  • 18 Shahid KR, Dellon AL, Amrami KK. et al. Sciatic and peroneal nerve injuries after endovascular ablation of lower extremity varicosities: case reports and review of the literature. Annals of plastic surgery 2015; 74 (01) 64-68
  • 19 Hirsch T. Varicose vein therapy and nerve lesions. VASA Zeitschrift für Gefasskrankheiten 2017; 46 (02) 96-100
  • 20 Haridas M, Malangoni MA. Predictive factors for surgical site infection in general surgery. Surgery 2008; 144 (04) 496-501
  • 21 Mekako A, Chetter I. Cutaneous hyperpigmentation after endovenous laser therapy: a case report and literature review. Annals of vascular surgery 2007; 21 (05) 637-639
  • 22 Goldman MP, Sadick NS, Weiss RA. Cutaneous necrosis, telangiectatic matting, and hyperpigmentation following sclerotherapy. Etiology, prevention, and treatment. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al] 1995; 21 (01) 19-29
  • 23 Aleksic I, Busch T, Sirbu H. et al. Successful reconstruction of stripped superficial femoral vein. J Vasc Surg 2001; 33 (05) 1111-1113
  • 24 Liddicoat JE, Bekassy SM, Daniell MB. et al. Inadvertent femoral artery „stripping“: Surgical management. Surgery 1975; 77 (02) 318-320
  • 25 van den Bos RR, Neumann M, Nijsten T. Laser fibre stabs the catheter: a serious complication of endovenous laser ablation. Phlebology 2011; 26 (03) 119-120
  • 26 Van Den Bos RR, Neumann M, De Roos KP. et al. Endovenous laser ablation-induced complications: review of the literature and new cases. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al] 2009; 35 (08) 1206-1214
  • 27 Wheatcroft MD, Lindsay TF, Lossing A. Two cases of arteriovenous fistula formation between the external iliac vessels following endovenous laser therapy. Vascular 2014; 22 (06) 464-467
  • 28 Ostler AE, Holdstock JM, Harrison CC. et al. Arterial false aneurysm in the groin following endovenous laser ablation. Phlebology 2015; 30 (03) 220-222
  • 29 Leong JCY, Johnston NR. Visual loss following sclerotherapy for varicose veins. BMJ Case Reports 2011; 2011: bcr0720103148
  • 30 Kim M, Niroumandpour M, Poustinchian B. Transient Ischemic Attack After Foam Sclerotherapy in a Woman With a Patent Foramen Ovale. The Journal of the American Osteopathic Association 2016; 116 (05) 320-323
  • 31 Frings N, Brenner E, Prinz N. et al. Paraplegia following sclerotherapy of leg veins. Phlebologie 2017; 46 (02) 92-97
  • 32 Rass K, Frings N, Glowacki P. et al. Same Site Recurrence is More Frequent After Endovenous Laser Ablation Compared with High Ligation and Stripping of the Great Saphenous Vein: 5 year Results of a Randomized Clinical Trial (RELACS Study). Eur J Vasc Endovasc Surg 2015; 50 (05) 648-656
  • 33 Hamann SAS, Giang J, De Maeseneer MGR. et al. Editor‘s Choice – Five Year Results of Great Saphenous Vein Treatment: A Meta-analysis. Eur J Vasc Endovasc Surg 2017; 54 (06) 760-770