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A Journal on Phlebology
Acta Phlebologica 2013 December;14(3):109-14
Hemodynamic surgery versus conventional surgery in chronic venous disease: a multicenter retrospective study
De Franciscis S. 1, 2, Gasbarro V. 1, 3, Amato B. 1, 4, Buffone G. 2, Grande R. 2, Serra R. 1, 2
1 Interuniversity Center of Phlebolymphology Magna Graecia University of Catanzaro Catanzaro, Italy;
2 Department of Medical and Surgical Science Magna Graecia University of Catanzaro Catanzaro, Italy;
3 Department of Vascular Surgery University of Ferrara, Ferrara, Italy;
4 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies “Federico II” University of Naples, Naples, Italy
Aim: Chronic venous disease (CVD) is a common disease with a high prevalence in western countries. Standard open varicose vein surgery, usually sapheno-femoral junction ligation, great saphenous vein stripping and multiple phlebectomies, has been used to treat varicose veins for a long time. Within the last decade new alternatives to surgical treatment have been developed such us hemodynamic surgery. Aim of this study was to compare hemodynamic strategy versus standard open surgery.
Methods: A retrospective multicenter study, between 1994 and 2012, was conducted; 11026 patients (4051 M; 6975F) with CVD were surgically treated for their conditions (median age 45.5 years; age range 21-67); 6044 were treated with CHIVA procedure (Group A) and 4982 were treated with Stripping procedure (Group B). All patients were followed-up for the following parameters: pain; edema; ectasia; pigmentation; duplex ultrasound controls; recurrence rate.
Results: The median follow-up was 9 years for both groups. Duplex controls showed in Group A (CHIVA) respect to Group B (stripping), from the very beginning of follow-up, an optimal improvement of hemodynamic situation. Disappearance of symptoms and signs was more evident in Group B (stripping) compared to Group A (CHIVA) at the early follow-up. In the middle and in the late follow-up, a higher number of patients of Group A (CHIVA) showed an improvement of all symptoms and signs respect to Group B (stripping).
Conclusion: Hemodynamic surgery, compared to conventional surgery, seems to improve results improving clinical and instrumental conditions of treated patients reducing also recurrence of varicose veins.