Hemodynamics and Surgical Results of Chronic Venous Insufficiency with Skin Changes in the Lower Limbs

Preoperative hemodynamics in the lower limbs in 174 limbs of 103 patients were measured and investigated and the surgical results were evaluated. The subjects were divided into the C4-6-group, which included 51 limbs with skin changes, and the C2, 3-group, which consisted of 123 limbs without skin c...

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Published inJapanese Journal of Cardiovascular Surgery Vol. 25; no. 5; pp. 290 - 294
Main Authors Hoshino, Shunichi, Takase, Shinya, Satokawa, Hirono, Iwaya, Fumio, Igari, Tsuguo, Midorikawa, Hirohumi, Ogawa, Tomohiro
Format Journal Article
LanguageJapanese
Published The Japanese Society for Cardiovascular Surgery 1996
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ISSN0285-1474
1883-4108
DOI10.4326/jjcvs.25.290

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Abstract Preoperative hemodynamics in the lower limbs in 174 limbs of 103 patients were measured and investigated and the surgical results were evaluated. The subjects were divided into the C4-6-group, which included 51 limbs with skin changes, and the C2, 3-group, which consisted of 123 limbs without skin changes. Plethysmography showed that the maximum venous outflow was significantly higher, and the refilling time was shorter in the C4-6-group compared to the C2, 3-group. All C4-6-group patients had reflux of the long saphenous vein, and the reflux velocity and volume was significantly greater than in the C2, 3-group. Limbs with deep vein reflux accounted for 45% of the C4-6-group. We performed angioscopic deep vein external valvuloplasty in 23 of those limbs. There was no case of reccurence of skin changes at a mean follow-up of 22 months. However chronic venous insufficiency often was associated with multisegmental reflux lesions and in such cases it might be necessary to perform multiple surgical procedures to eliminate the reflux.
AbstractList Preoperative hemodynamics in the lower limbs in 174 limbs of 103 patients were measured and investigated and the surgical results were evaluated. The subjects were divided into the C4-6-group, which included 51 limbs with skin changes, and the C2, 3-group, which consisted of 123 limbs without skin changes. Plethysmography showed that the maximum venous outflow was significantly higher, and the refilling time was shorter in the C4-6-group compared to the C2, 3-group. All C4-6-group patients had reflux of the long saphenous vein, and the reflux velocity and volume was significantly greater than in the C2, 3-group. Limbs with deep vein reflux accounted for 45% of the C4-6-group. We performed angioscopic deep vein external valvuloplasty in 23 of those limbs. There was no case of reccurence of skin changes at a mean follow-up of 22 months. However chronic venous insufficiency often was associated with multisegmental reflux lesions and in such cases it might be necessary to perform multiple surgical procedures to eliminate the reflux.
Author Satokawa, Hirono
Iwaya, Fumio
Hoshino, Shunichi
Takase, Shinya
Ogawa, Tomohiro
Igari, Tsuguo
Midorikawa, Hirohumi
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  organization: Department of Cardiovascular Surgery, Fukushima Medical College
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References 10) Raju, S. and Fredericks, R.: Valve reconstruction procedures for nonobstructive venous insufficiency: rationale, techniques, and results in 107 procedures with two-to eight-year follow-up. J. Vasc. Surg. 7: 301-310, 1988.
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3) 佐戸川弘之, 岩谷文夫, 猪狩次雄ほか: 血管内視鏡による静脈弁の形態と分類. 脈管学32: 395-401, 1992.
9) Darke, S.G. and Penfold, C.: Venous ulceration and saphenous ligation. Eur. J. Vasc. Surg. 6: 4-9, 1992.
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1) Proter, J.M., Rutherford, B.R., Clagett, G.P. et al.: Reporting standards in venous disease. J. Vasc. Surg. 8: 172-181, 1988.
4) Browse, N.L., Burnand, K.G. and Lea Thomas, M.: Primary (nonthrombotic) deep vein incompetence. In Diseases of the Veins: Pathology, Diagnosis and Treatment. 1st ed., Edwards Arnold, London, 1988, pp. 253-269.
7) Cornwall, J.V., Dore, C.J. and Lewis, J.D.: Leg ulcers: epidermology and etiology. Br. J. Surg. 73: 693-696, 1986.
6) Vasdekis, S.N., Clarke, H. and Nicolaides, A. N.: Quantification of venous reflux by means of dupplex scanning. J. Vasc. Surg. 10: 670-677, 1989.
11) 星野俊一, 佐戸川弘之, 岩谷文夫ほか: 深部静脈不全に対する診断および逆流遮断. 6: 113-124, 1995.
References_xml – reference: 1) Proter, J.M., Rutherford, B.R., Clagett, G.P. et al.: Reporting standards in venous disease. J. Vasc. Surg. 8: 172-181, 1988.
– reference: 3) 佐戸川弘之, 岩谷文夫, 猪狩次雄ほか: 血管内視鏡による静脈弁の形態と分類. 脈管学32: 395-401, 1992.
– reference: 11) 星野俊一, 佐戸川弘之, 岩谷文夫ほか: 深部静脈不全に対する診断および逆流遮断. 6: 113-124, 1995.
– reference: 4) Browse, N.L., Burnand, K.G. and Lea Thomas, M.: Primary (nonthrombotic) deep vein incompetence. In Diseases of the Veins: Pathology, Diagnosis and Treatment. 1st ed., Edwards Arnold, London, 1988, pp. 253-269.
– reference: 2) Beebe, H.G., Bergan, J.J., Bergqvist, D. et al.: Classification and grading of chronic venous disease in the lower limb. 静脈学6: 103-108, 1995.
– reference: 6) Vasdekis, S.N., Clarke, H. and Nicolaides, A. N.: Quantification of venous reflux by means of dupplex scanning. J. Vasc. Surg. 10: 670-677, 1989.
– reference: 5) Train, J.S., Schanzer, H., Peirce, E. et al.: Radiological evaluation of the chronic venous stasis syndrome. JAMA 258: 941-944, 1987.
– reference: 8) Shami, S.K., Sarin, S., Cheatle, T.R. et al.: Venous ulcers and the superficial venous system. J. Vasc. Surg. 17: 487-490, 1993.
– reference: 9) Darke, S.G. and Penfold, C.: Venous ulceration and saphenous ligation. Eur. J. Vasc. Surg. 6: 4-9, 1992.
– reference: 7) Cornwall, J.V., Dore, C.J. and Lewis, J.D.: Leg ulcers: epidermology and etiology. Br. J. Surg. 73: 693-696, 1986.
– reference: 10) Raju, S. and Fredericks, R.: Valve reconstruction procedures for nonobstructive venous insufficiency: rationale, techniques, and results in 107 procedures with two-to eight-year follow-up. J. Vasc. Surg. 7: 301-310, 1988.
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Title Hemodynamics and Surgical Results of Chronic Venous Insufficiency with Skin Changes in the Lower Limbs
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