Topic
Anterior accessory saphenous vein
About: Anterior accessory saphenous vein is a research topic. Over the lifetime, 52 publications have been published within this topic receiving 1536 citations.
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TL;DR: The Society for Vascular Surgery and the American Venous Forum have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis, including recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases.
1,162 citations
TL;DR: EVLA of GSV and SSV with a 1470 nm diode laser is a minimally invasive, safe and efficient therapy option with a high success rate one year after treatment, however, with LEED > 100 J/cm in this study, the incidence of paresthesia rose significantly.
Abstract: Introduction: Most of the published EVLA data concern 810, 940, 980 nm diode lasers and 1064 or 1320 nm Nd:Yag laser systems. Major side effects are postoperative pain and bruising. The aim of this study was to show the outcome one year after EVLA of incompetent saphenous veins with a 1470 nm Diode laser (Ceralas E, biolitec). Patients and method: Between December 2006 and February 2007, 134 saphenous veins (108 GSV, 26 SSV) in 117 legs of 100 consecutive patients where treated by EVLA for GSV and SSV incompetence. All patients were examined clinically and with duplex by an experienced phlebologist prior to intervention, and at the follow-up visits for complications, occlusion, flow and reflux in the treated vein segment. The clinical evaluation included clinical CEAP and the presence of recurrent varicose veins. Patient satisfaction was assessed by a 0 to 4 scale. Results: After a mean follow-up period of 184 days (SD 27) 127 treated veins (102 GSV, 25 SSV) of 111 limbs in 94 patients and after 329 days (SD 14) 105 treated veins (94 GSV, 21 SSV) of 105 limbs in 83 patients were reinvestigated. Six patients were lost to follow up after six months and an additional 11 patients after one year. Up to one year follow-up all treated veins remained occluded. At six months, one new insufficient anterior accessory saphenous vein (AASV) and after 12 months, three new insufficient AASV occurred. After one year 45 patients were very satisfied with the method, 34 were satisfied, three were fairly and one was not satisfied. The mean of all answers was 0.5 (SD 0.5). In three cases phlebitic reactions after 10 days, but no severe complications such as deep vein thrombosis occured. After six months in 9.5% of the legs paresthesia was present in the treated area which reduced to 7.6% after one year. Intake of painkillers was mean 6.7 tablets (SD 3.5). When we compared GSV legs treated with LEED below or above 100 J/cm, the paresthesia rate was significantly lower in the first group with 2.3% compared to 15.5 % in the higher LEED group. The differences for number of days with analgesic intake and for the paraesthetic area were significant. Discussion: In this prospective follow-up study with 100 consecutive patients and 134 treated saphenous veins a high occlusion rate of 100% could be demonstrated one year after treatment. However, with LEED . 100 J/cm in this study, the incidence of paresthesia rose significantly. Therefore it seems adequate to stay below 100 J/cm in the future as the occlusion rate was the same below and above 100 J/cm.
142 citations
TL;DR: There is no difference in the incidence of REVAS for EVA vs L&S, but the causes of REvAS are different with L &S, which has important implications for treatment.
Abstract: Background Recurrence of varicose veins after surgery (REVAS) for saphenous incompetence has been well described after ligation and stripping (LS 40 of 125 limbs), followed by the development of anterior accessory saphenous vein incompetence (19%; 23 of 125 limbs). In contrast to other reports, incompetent calf perforating veins were an infrequent cause of REVAS (7%; eight of 125). Conclusions There is no difference in the incidence of REVAS for EVA vs L&S, but the causes of REVAS are different with L&S, which has important implications for treatment.
84 citations
TL;DR: UGFS for CEAP 2-6 SVR is associated with a low complication and retreatment rate, however, as patients are at risk of developing recurrent and new SVR they should be kept under review.
81 citations
TL;DR: The absence of any fascial ensheathing and the parietal weakness are suggestive of a lower resistance of the TVs wall to increased endovascular pressure, which would explain why varicose changes occurring in the TVs are usually greater than those occur in the affected SVs.
Abstract: The objective was to define planar anatomy, fascial relationships and structure of the tributary vessels (TVs) of the saphenous veins (SVs). The gross anatomy of the TVs was evaluated by dissection in cadaver limbs and by sonography and computerized tomography in healthy volunteers. Correlated light microscopy and scanning electron microscopy were used to evaluate and compare the wall structure in 45 specimens of SVs and 122 specimens of TVs. The TVs showed a subdermal path and were surrounded by an amorphous fatty tissue. Only the "Giacomini's vein" and the cranial segment of the "anterior accessory saphenous vein" ran deeply in the hypodermis, ensheathed by the muscular fascia and the membranous layer of the hypodermis. The wall of the TVs was weaker than that of the SVs due to the absence of intimal hyperplasia, to lesser muscularization and to scarce connective tissue proliferation. The absence of any fascial ensheathing and the parietal weakness are suggestive of a lower resistance of the TVs wall to increased endovascular pressure. This would explain why varicose changes occurring in the TVs are usually greater than those occurring in the affected SVs.
63 citations