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A Journal on Phlebology
Acta Phlebologica 2004 December;5(2-3):23-9
language: English, Italian
Current role of surgery in superficial chronic venous insufficiency
De Franciscis S., Serra R., Luongo A., Ciranni S., Roscitano G.
Surgical Clinical Methodology, Vascular Surgery Training Program, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
AIM: Superficial chronic venous insufficiency (S-CVI) is a disease of Western civilization. The cause of varicose veins is probably multifactorial but venous hypertension is clearly the primary cause.Aim of this study is to demonstrate that surgical treatment of S-CVI must be based on correct pathophysiological and haemodynamic principle.
METHODS: Two thousand one hundred and seventy-three patients were treated and followed in a period of 8 years (1994-2002): 1 106 patients underwent CHIVA procedure and 1 067 patients underwent stripping procedure. All patients were followed up for 5 years. Follow-up parameters were: pain, oedema, ectasia, pigmentation, ultrasound controls, recurrence.
RESULTS: In the beginning of the follow up results of patients who underwent stripping procedure were more satifactory than CHIVA groups because of a rapid improvement of symptoms and signs and an apparent very good recovery of functionality of the operated lower limb. In the middle and in the end of the follow-up period some patients of CHIVA underwent CHIVA group surpassed. Stripping group because of a greater objective and subjective benefit especially in those patients who underwent retouches during follow-up.
CONCLUSION: Nowadays there is no need to argue about ablative or restaurative techniques because every technique can be used if is able to respect some strategic and tactical rules that spring from haemodynamic studies. We have to argue, therefore, about haemodynamic surgery.