DOI: http://dx.doi.org/10.18203/2349-2902.isj20192988

Management and outcome of lower limb varicose veins: a hospital based follow up study

G. V. Ramana Reddy, V. Abhilash, Y. Harshavardhan, B. Ravikiran

Abstract


Background: Disorders of veins which are chronic in nature and very common are the varicose veins. Surgery is required at any one stage of the disease. There have been considerable advances that took place in the diagnostics of the varicose veins, but the treatment outcomes may not be good in many cases. To study the management and outcome of lower limbs varicose veins.

Methods: This was a hospital based follow up study. Patients who presented with varicose veins signs and symptoms were included. During the study period it was possible to include 40 patients who were willing to get included in the present study. Various presentations, complications and treatments were noted and finally followed up for minimum of 3 months.

Results: Most commonly affected age group was 36-45 years. Males were four times more affected than females. Most commonly affected limb was left side in 48%. Long saphenous system was involved in 55%. The predominant symptom was dilated and tortuous veins (32%) followed by pain (25%). 65 incompetent perforators identified by clinical examination and 130 by Doppler with above ankle being the commonest incompetent perforator. With the mean follow up of six months, no serious complications were noted. It was found that the sensitivity of the clinical examination was 82% when doppler scan was taken as gold standard. On follow up no one developed deep vein thrombosis. Incompetence recurrence rate at SFJ was 8% and at SPJ was 18%.

Conclusions: We conclude that surgery is the first line of management and if done accurately, complications are minimal.


Keywords


Doppler, Stripping, Varicose vein

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References


Callam MJ. “Varicose Veins.” In: Callam MJ, editor. Essential Surgical Practice, Module 34, 4th edition, Hodder Arnold Publications; 2002: 879-890.

Johnson G. ‘Management of venous disorders’. In: Vascular surgery by Rutherford RB, 4th edn. Vol II, W.B. Sounders Company;1995: 1671-1862.

Williams PJ, Bannister LH. Berry MM. “Veins of Lower Limb” in Grey’s Anatomy, Churchill Livingstone publications Chapter 10. 38th edn. 1995: 1595-1598.

Carlos L, Junquier, Carneiro J, “The Circulatory System. In: Basic Histology - Text and atlas. Chapter 11. 10th edn. Lange Publications; 225-230.

Campbell WB, Ridler BMF, Halim AS. The place of duplex scanning for varicose veins and common venous problems. Ann R Coll Surg Engl. 1996;78:490-3.

Bradbury A, Evans C, Allan P. What are the symptoms of varicose veins Edinburgh vein study cross-sectional population survey. Br Med J. 1999;318:353-5.

Russell RCG, Williams NS, Bulstrode CJK. Venous disorders. In: Bailey and Love’s Short practice of surgery. Chapter 24. 24th edn; Arnold publications; 2004: 954-973

Ahti TM, Makivaara L, Luukkaala T. Effect of family history on the incidence of varicose veins: a population-based follow-up study in Finland. Angiol. 2009;60(4):487-91.

Barwell JR, Davies CE, Deacon J. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet. 2004;363(9424):1854-9.

Michaels JA, Campbell WB, Brazier JE. Randomised clinical trial, observational study and assessment of cost-effectiveness of the treatment of varicose veins (REACTIV trial) Health Technol Assess. 2006;10:1-196.

Defty C, Eardley N, Taylor M. A comparison of the complication rates following unilateral and bilateral varicose vein surgery. Eur J Vasc Endovasc Surg. 2008;35:745-9.

Van Rij AM, Jiang P, Solomon C. Recurrence after varicose vein surgery: a prospective long-term clinical study with duplex ultrasound scanning and air plethysmography. J Vasc Surg. 2003;38(5):935-43.