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Phlebologie 2000; 29(03): 58-61
DOI: 10.1055/s-0037-1617235
Originalarbeit
Schattauer GmbH

Recurrent varicose veins assessed by colour-coded duplex scanning: own experience

W. Staszkiewicz
1   Department of Vascular Surgery (Head of Dept.: Prof. Dr. W. Staszkiewicz), Postgraduate Medical Centre, Warsaw, Poland
,
G. Madycki
1   Department of Vascular Surgery (Head of Dept.: Prof. Dr. W. Staszkiewicz), Postgraduate Medical Centre, Warsaw, Poland
,
P. Dabek
1   Department of Vascular Surgery (Head of Dept.: Prof. Dr. W. Staszkiewicz), Postgraduate Medical Centre, Warsaw, Poland
,
A. Gabrusiewicz
1   Department of Vascular Surgery (Head of Dept.: Prof. Dr. W. Staszkiewicz), Postgraduate Medical Centre, Warsaw, Poland
› Author Affiliations
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Publication History

Publication Date:
29 December 2017 (online)

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Summary

Aim: Authors performed a retrospective analysis of causes of recurrent varicose veins following surgery. Methods: They evaluated 89 patients (65 women and 24 men, mean age 49.7 years). All patients previously underwent same surgical procedures (long saphenous vein stripping with/without local multiple avulsions). For the purpose of the study, colour/duplex examinations were applied (Siemens Sonoline Elegra unit). Results: Depending on the type and area of recurrent varicose veins, patients were classified into 4 groups. Group I – 22 patients (persistence of varicose tributaries of LSV in thigh or thigh perforator). Group II – 27 patients (recurrence along the LSV in the calf). Group III – 26 patients (recurrence due to left incompetent short saphenous vein). Group IV – 14 patients (isolated incompetent perforators). Authors conclude, that colour-coded duplex scanning is currently a method of choice in the diagnosis of recurrent varicose veins. High incidence of recurrence due to short saphenous vein incompetence should draw particular attention to this vein in the preoperative assessment of venous system. Recurrence of varicose veins at thigh level is not caused by deep vein insufficiency, but is related to inadequate vein surgery or might be linked to the problem of neovascularisation in this area.

Zusammenfassung

Ziel: Die Autoren führten eine retrospektive Analyse der Ursachen von Varizen-Rezidiven nach erfolgter Operation durch. Methoden: Sie untersuchten 89 Patienten (65 Frauen und 24 Männer, Durchschnittsalter: 49,7 Jahre). Bei allen Patienten waren zuvor dieselben operativen Eingriffe durchgeführt worden (Stripping der Vena saphena magna mit/ohne lokale multiple Exhäresen). Zum Zweck der Studie wurden Farbduplex- Untersuchungen durchgeführt (Siemens Sonoline Elegra unit). Ergebnisse: Je nach Art und Bereich der Varizen- Rezidive wurden die Patienten in 4 Gruppen eingeteilt. Gruppe I – 22 Patienten (Persistenz von varikösen Seitenästen der VSM im Bereich von Oberschenkel oder Oberschenkel-Perforansvenen). Gruppe II – 27 Patienten (Rezidiv entlang der VSM in der Wade). Gruppe III – 26 Patienten (Rezidiv infolge einer verbliebenen Insuffizienz der Vena saphena parva). Gruppe IV – 14 Patienten (isolierte insuffiziente Perforansvenen). Die Autoren kommen zu dem Schluß, daß die farbkodierte Duplex-Sonographie derzeit die Methode der Wahl bei der Diagnose von Varizen-Rezidiven ist. Aufgrund der hohen Inzidenz von Rezidiven infolge einer Insuffizienz der Vena saphena parva sollte auf diese Vene bei der präoperativen Untersuchung des Venensystems besonders geachtet werden. Varizen-Rezidive auf Oberschenkelhöhe werden nicht durch eine Insuffizienz tiefer Venen verursacht, sondern sind bedingt durch eine unzulängliche Venenoperation oder könnten mit dem Problem einer Neovaskularisation in diesem Bereich zusammenhängen.

Résumé

Objet: Les auteurs ont effectué une analyse rétrospective des causes des varices récurrentes suite à une opération. Méthode: Ils ont évalué 89 patients (65 femmes et 24 hommes, âge moyen – 49,7 ans). Tous les patients avaient subi la même intervention chirurgicale auparavant (stripping de la veine saphène grande avec/sans avulsions locales multiples). Pour le but de l’étude, des examens en couleur/duplex ont été effectués (unité Siemens Sonoline Elegra). Résultats: En fonction du type et de la région des varices récurrentes, les patients ont été classés en 4 groupes. Groupe I – 22 patients (persistance des varices tributaires de la veine saphène grande dans la cuisse ou dans le perforateur de la cuisse). Groupe II – 27 patients (récurrence le long de la veine saphène grande dans le mollet). Groupe III – 26 patients (récurrence due à la veine saphène petite gauche incompétente). Groupe IV – 14 patients (perforateurs isolés incompétents). Les auteurs en ont conclu que le balayage duplex à codage couleur est actuellement la méthode de choix pour le diagnostic des varices récurrentes. La haute incidence de la récurrence due à la veine saphène petite devrait particulièrement attirer l’attention sur cette veine lors de l’évaluation postopératoire du système veineux. La récurrence des varices au niveau de la cuisse n’est pas causée par une insuffisance des veines profondes, mais elle est due à une chirurgie veineuse inadéquate ou pourrait être liée au problème de la néovascularisation dans cette zone. Correspondence to: Prof. W. Staszkiewicz Department of Vascular Surgery, Postgraduate Medical Centre, Ul. Goszczyn‘skiego 1, 02-616 Warsaw, Poland

Keywords

Ultrasound - recurrent varicose veins - noninvasive diagnosis

Schlüsselwörter

Ultraschall - Varizen-Rezidive - nichtinvasive Diagnose

Mots clés

Ultrason - varices récurrentes - diagnostic noninvasif
 

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