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Thromb Haemost 1995; 73(04): 597-600
DOI: 10.1055/s-0038-1653827
Original Articles
Clinical Studies
Schattauer GmbH Stuttgart

Varicose Vein Stripping - A Prospective Study of the Thrombotic Risk and the Diagnostic Significance of Preoperative Color Coded Duplex Sonography

Kornelia Böhler
1   The Department of Dermatology, Division of General Dermatology, University of Vienna, Medical School, Vienna, Austria
,
Manfred Baldt
2   Department of Radiology, University of Vienna, Medical School, Vienna, Austria
,
Sanja Schuller-Petrovic
1   The Department of Dermatology, Division of General Dermatology, University of Vienna, Medical School, Vienna, Austria
,
Christian Grünwald
1   The Department of Dermatology, Division of General Dermatology, University of Vienna, Medical School, Vienna, Austria
,
Wolfgang Sellner
1   The Department of Dermatology, Division of General Dermatology, University of Vienna, Medical School, Vienna, Austria
,
Herbert Watzke
3   Department of Internal Medicine I, Division of Hematology and Hemostaseology, University of Vienna, Medical School, Vienna, Austria
,
Klaus Wolff
1   The Department of Dermatology, Division of General Dermatology, University of Vienna, Medical School, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received 17 October 1994

Accepted after revision 03 January 1995

Publication Date:
09 July 2018 (online)

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Summary

Insufficiency of epifascial veins promotes venous ulceration and increases thromboembolic risk in general surgery patients. Epifascial varicose vein stripping is therefore considered the most effective prophylactic procedure. Thromboembolic risk of patients undergoing this surgical procedure has not yet been prospectively evaluated but appears to be lower than in general surgery patients. The gold standard of preoperative assessment of varicose surgery patients is ascending pressure phlebography, but this technique is invasive, time consuming and costly.

We prospectively investigated 100 consecutive varicose vein surgery patients for postoperative thrombosis. Ascending pressure phlebography (APP) and colour coded duplex sonography (CCDS) were performed before and 10 to 21 days after the stripping operation in 100 and 70 patients, respectively.

APP revealed no postoperative deep vein thrombosis in all 100 limbs investigated (0 percent; 95 percent confidence interval: 0 to 2.95). With regard to epifascial vein reflux there was good agreement between APP and CCDS (quadratic weighted kappa: 0.76). In 67 out of 73 superficial veins investigated excellent agreement of diagnostic accuracy was found for both diagnostic procedures (91.78 percent; 95 percent confidence interval: 82.96 to 96.92).

We conclude that thrombotic risk of varicose vein surgery is low in properly selected patients. CCDS provides a high degree of accuracy in diagnosis of reflux and regular vein morphology and should therefore replace APP; however, APP does remain essential in the preoperative workup of a typical anatomical variants.

 

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