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.

Accessory and great saphenous veins as coronary artery bypass conduits.

Abstract: Anatomic, histologic and ultrasound studies demonstrate two distinct types of longitudinal veins in the lower extremities. The great saphenous vein is deep to the saphenous fascia. Accessory saphenous veins are superficial to this layer, have thin walls with diminished muscle cells and elastic fibers. Vein characteristics may affect long-term graft patency. This study assesses the incidence of accessory saphenous veins in various patient groups and evaluates issues related to their use as coronary conduits. Ultrasound imaging assessed great and accessory saphenous veins in 476 normal limbs, in 42 patients post-saphenous vein harvesting and in 75 patients undergoing coronary revascularization. Accessory saphenous veins are found in 67% of normal subjects. Intraoperative ultrasound identifies accessory saphenous veins in 54% of limbs, most in the proximal calf where 42% of all accessory vein segments are located. Great saphenous vein segments are more common in males while accessory veins are more common in females. In 54 limbs following saphenectomy, patent great saphenous vein segments are demonstrated in 20%, adjacent to incision sites, indicating use of accessory saphenous veins in these patients. Ultrasound studies at two medical centers document the common occurrence of accessory saphenous veins. Additional studies are required to determine the efficacy of utilizing accessory saphenous vein segments for coronary artery bypass conduits.

Safety and efficacy of endovenous ablations in octogenarians, nonagenarians, and centenarians.

Abstract: Objective Endovenous ablation of the lower extremity veins has become the primary treatment of symptomatic venous reflux disease. Endovenous heat-induced thrombosis (EHIT) and recanalization are two well-known complications of these venous ablative procedures. Because the elderly represent the fastest growing demographic, our goal was to look at whether there is a difference of these complications and age distribution in octogenarians, nonagenarians, and centenarians vs the younger population. Methods A retrospective study was conducted of 10,029 procedures that were performed from March 2012 to September 2018 on 8273 veins across 3218 patients who underwent endovenous ablation for lower extremity venous reflux; 6091 procedures were performed with radiofrequency ablation, and 3938 were performed with endovenous laser ablation. We reviewed charts of all patients who underwent radiofrequency ablation or endovenous laser treatment during this time. Postprocedural venous duplex ultrasound was performed at 3 to 7 days to check for EHIT and recanalization, every 3 months for the first year, and every 6 to 12 months thereafter. The χ2 test and analysis of variance were used for statistical analysis. Results Ages ranged from 15 years to 103 years. The average age of the patients was 61.9 ± 15.2 years. Average overall follow-up for all age groups was 25.8 ± 12.9 months. Of the 3218 patients, 2700 were younger than 80 years, 380 were between 80 and 89 years, 132 were between 90 and 99 years, and 6 were 100 years or older. Of the 10,029 procedures, 8730 were performed on patients younger than 80 years; 1124, on patients 80 to 89 years; 159, on patients 90 to 99 years; and 16, on patients 100 years or older. There were 111 patients who had bilateral procedures in the accessory saphenous vein, 1878 patients who had bilateral procedures in the great saphenous vein, 99 patients who had bilateral procedures in the perforator vein, and 760 patients who had bilateral procedures in the small saphenous vein. There were statistically significant increases in EHIT rates between octogenarians and those in the age group Conclusions Whereas there is a relatively higher chance of EHIT and recanalization in the age group >80 years, our study shows that the majority of EHITs were class 1 and class 2. According to our study, venous ablation is safe and effective across all age groups, and age alone should not be used to deny patients venous ablations.

Endovenous treatment of incompetent anterior accessory saphenous veins with a 1540 nm diode laser.

Abstract: Aim Endovenous laser treatment (EVLT) is an accepted form of axial vein ablation for symptomatic venous reflux but its role in the treatment of anterior accessory saphenous vein (AASV) has not been well characterized. The aim of this paper is to show the short-term result of EVLT with a ball-tipped fiber and a 1540 nm diode laser of the AASV with preservation of a competent great saphenous vein (GSV). Methods Nine incompetent AASV veins in 8 patients (6 female) were treated. The gravity of chronic venous disease was determined according to the CEAP classification and the severity of symptoms was scored according to the revised Venous Clinical Severity Score. Patient satisfaction was assessed by a 0 to 3 scale. Results The average linear endovenous energy density was 60.5 J/cm vein (SD: 7.5). Patients returned to daily activities after a mean of 3.8 days (SD: 1.4). 5 patients (63%) have had pain but of mild intensity. No patients developed paresthesia or phlebitis reactions in the treated area. Post-operative ecchymoses are frequent (89%). During the follow-up period (mean 13 months, range: 7-17 months) all the veins were occluded. The VCSS improved drastically from a mean of 3.2 (SD: 1.3) preinterventional to 0 (SD: 0.38) at 17 months. All patients were satisfied or very satisfied with the method. No severe complications occurred. Conclusion EVLT of an incompetent AASV with a 1540 nm diode laser is a safe and efficient therapy option, with a high success rate and with no evidence of GSV neo-reflux or recurrent varicosities during the follow-up period.

Institutional report - Coronary Accessory and great saphenous veins as coronary artery bypass conduits

Abstract: Anatomic, histologic and ultrasound studies demonstrate two distinct types of longitudinal veins in the lower extremities. The great saphenous vein is deep to the saphenous fascia. Accessory saphenous veins are superficial to this layer, have thin walls with diminished muscle cells and elastic fibers. Vein characteristics may affect long-term graft patency. This study assesses the incidence of accessory saphenous veins in various patient groups and evaluates issues related to their use as coronary conduits. Ultrasound imaging assessed great and accessory saphenous veins in 476 normal limbs, in 42 patients post-saphenous vein harvesting and in 75 patients undergoing coronary revascularization. Accessory saphenous veins are found in 67% of normal subjects. Intraoperative ultrasound identifies accessory saphenous veins in 54% of limbs, most in the proximal calf where 42% of all accessory vein segments are located. Great saphenous vein segments are more common in males while accessory veins are more common in females. In 54 limbs following saphenectomy, patent great saphenous vein segments are demonstrated in 20%, adjacent to incision sites, indicating use of accessory saphenous veins in these patients. Ultrasound studies at two medical centers document the common occurrence of accessory saphenous veins. Additional studies are required to determine the efficacy of utilizing accessory saphenous vein segments for coronary artery bypass conduits. 2006 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

Recurrence types 3 years after endovenous thermal ablation in insufficient saphenofemoral junctions.

Abstract: Objective Although many studies have demonstrated that endovenous therapies have comparable efficacy to crossectomy and stripping, few studies have been published regarding the classification and recurrence patterns of varicose veins after endovenous therapy. This study attempted to provide an objective scheme for the definition and classification of recurrence. Moreover, it describes the types and rates of recurrence after endovenous thermal ablation, as well as factors associated with recurrence. Methods This prospective cohort study comprised a cohort of 449 patients with saphenofemoral junction (SFJ) insufficiency who underwent endoluminal varicose vein treatment for the first time in the limb between October 2013 and January 2015. The treatments were performed by a team of three experienced phlebologists. For endovenous laser ablation, Biolitec ELVeS was used with bare, radial or radial slim fibers. Radiofrequency ablation was performed with VNUS ClosureFAST (Medtronic, Deggendorf, Germany). The patients were consecutively scheduled for 3-year follow-up examinations. Detailed ultrasound findings were collected by two experienced phlebologists who classified the observed duplex ultrasound recurrence into different recurrence types. Results Clinically relevant recurrence was found in only 5.1% of cases. Examining only the recanalizations requiring reintervention resulted in a recurrence rate of 2.6%. However, if every new varicose vein that occurred postoperatively was considered a recurrence, the resultant recurrence rate was almost 54%. Preliminarily, we defined a recurrence as newly developed varicose veins within the region of the SFJ or along the course of the former treated vein distal to the SFJ. According to this definition, we obtained a clinically relevant recurrence rate of 5.3%, thus indicating that neovascular vessels were the largest recurrence type (57.7% within the region of the SFJ and 9.9% distal to the SFJ), followed by recanalization (8.9% within the region of the SFJ and 9.4% distal to the SFJ) and a refluxing anterior accessory saphenous vein (7.5%). We also developed a modified classification of progression to better understand recurrence after treatment of chronic venous insufficiency; the scheme included method failure (recanalization), neovascularizations, and disease progression (refluxing untreated vessels and new varicose veins occurring outside the treated region). The diameter of the treated vein (P = .001) and the clinical class according to CEAP classification (P = .008) were significant predictors of recurrence. Conclusions Endoluminal therapies are efficient methods for the treatment of varicose veins, which result in low recurrence rates after 3 years. Several factors influence the development of recurrence. This study provides a practice-oriented classification and description of recurrence with clinical relevance, through making distinctions among technical error, progression of the underlying disease and actual recurrence.