The selective use of duplex scanning in the pre-operative assessment of primary and uncomplicated varicose veins identifies patients with 'early' morphological disease.
Afr J Med Med Sci
; 29(1): 35-9, 2000 Mar.
Article
de En
| MEDLINE
| ID: mdl-11379465
The standard management of primary lower limb varicosities (stripping of the long saphenous vein (LSV) with avulsion of the varicosities) is based on the assumption that the disease originates from primary valvular insufficiency and incompetent perforating veins. It has recently been suggested that the LSV may be spared in patients with superficial varicosities without incompetence of this vein, i.e., early disease. However, pre-operative identification of suitable patients for conservative surgery has proved difficult. In this study, we employed selective duplex scanning in cases with primary varicosity in whom sapheno-femoral and sapheno-popliteal incompetence had been excluded both clinically and with the hand-held Doppler (52 limbs [10% of new referrals]). We found that the varicosities in these limbs were of 3 types: (a) those arising independent of superficial vein incompetence (Type 1); (b) those associated with segmental LSV incompetence (Type 2); (c) those in whom incompetence of the sapheno-femoral junction and LSV was missed (Type 3). We therefore suggest that long saphenous varicosity may progress from Type 1 through to Type 3 with each type representing an increase in severity of the disease. We suggest that selective use of duplex scanning will assist in identifying those patients with early stages of the disease who can then be treated effectively with LSV-sparing surgery.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Varices
/
Soins préopératoires
/
Dépistage de masse
/
Échographie-doppler duplex
/
Sélection de patients
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Screening_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Afr J Med Med Sci
Année:
2000
Type de document:
Article
Pays d'affiliation:
Royaume-Uni
Pays de publication:
Nigeria