Surgery of the superficial venous system in elderly patients
| Autor: | Natan Poluksht, David Chayen, Arie Bass, Eran E. Weinmann |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Duplex ultrasonography Chronic venous insufficiency 030204 cardiovascular system & hematology Severity of Illness Index Long Saphenous Vein Cohort Studies Varicose Veins 03 medical and health sciences 0302 clinical medicine Outcome Assessment Health Care medicine Humans 030212 general & internal medicine Aged Ultrasonography Aged 80 and over Groin business.industry Vascular disease Reflux Age Factors General Medicine medicine.disease Surgery medicine.anatomical_structure Venous Insufficiency Cellulitis Ambulatory Chronic Disease Quality of Life Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Vascular and endovascular surgery. 37(2) |
| ISSN: | 1538-5744 |
| Popis: | Chronic venous insufficiency, which traditionally has been attributed to failure of the deep venous system, may result from reflux in the superficial venous system. Chronic venous insufficiency is common in elderly patients, but surgical treatment is seldom offered to this patient population. We evaluated the results of superficial venous surgery for the treatment of severe chronic venous insufficiency in a cohort of elderly patients. The authors assessed patients aged 70 years or more with chronic venous insufficiency that had failed conventional conservative treatment. The superficial and deep venous systems were thoroughly investigated by duplex ultrasonography. Associated medical conditions were reevaluated and their treatment optimized. Twenty-eight patients (11 men, 17 women), aged between 70 and 89 years (mean 79), underwent superficial venous surgery. Open ulcers, active dermatitis and recurrent erysipelas were evident in 12, 9 and 7 patients, respectively. Limb swelling and severe pain were present in 25 (89%). The operations were performed under general or regional anesthesia with overnight hospitalization. Surgical treatment consisted of ligation of the points of reflux at the junctions of the superficial and deep systems, as defined by the duplex examination (21 saphenofemoral junctions, 5 saphenopopliteal junctions, 10 perforator veins), and stripping of the long saphenous vein to knee level (15 patients). Postoperative ambulatory treatment was continued until the wounds were completely closed. All ulcers healed completely within 8 weeks. No cardiac, respiratory, or renal complications were encountered. Wound infection at the groin occurred in 1 patient. Cellulitis of the calf area developed in 4 patients. Two ulcers recurred during follow-up of 1 to 5 years (mean 2.5). Surgery of the superficial venous system for treatment of severe chronic venous insufficiency is effective and can be achieved with minimal morbidity in selected elderly patients. The risk/benefit ratio for this procedure has been reduced sufficiently to ensure a major improvement in the quality of life of such patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|