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CURRENT ISSUEITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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ORIGINAL ARTICLES  


Giornale Italiano di Chirurgia Vascolare 2002 December;9(4):381-7

language: English, Italian

Isolated short saphenous vein insufficiency and lateral venous ulcer

Luzzani L., Bellosta R., Carugati C., Sarcina A.

Operative Unit of Vascular Surgery ­“Casa di ­Cura Pol­i­am­bu­lanza”, Brescia


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Back­ground. The pur­pose of the ­paper is to ­show ­that iso­lated ­refluxes in the ­short saph­e­nous may be the ­cause of ­ulcer for­ma­tion in the lat­eral per­i­mal­le­olar, and to ­verify the effec­tive­ness of com­bined strip­ping of the ­short saph­e­nous ­vein and ­dermo-epi­dermic ­grafts on the ­ulcer.
­Methods. ­From Sep­tember 1997 to ­December 2000 at the Vas­cular Sur­gery Func­tional ­Unit of the ­Casa di ­Cura Pol­i­am­bu­lanza of ­Brescia we ­observed 49 ­patients/1170 (4.1%) ­with iso­lated insuf­fi­ciency of the ­short saph­e­nous ­vein and ­normo-con­ti­nence of the ­remaining saph­e­nous ­system; in 14% of the ­cases (7 ­patients), an ­ulcer was ­present. All ­patients ­were C6-Ep-As4-Pr ­class. ­Echo ­color-Dop­pler con­firmed the pres­ence of ­reflux at the ­level of the ­sapheno-pop­li­teal ­arch and ­patency ­with ­normo-con­ti­nence of the ­deep ­venous ­system. Strip­ping of the ­short saph­e­nous was car­ried out in all 7 ­cases, asso­ciated in 6 ­cases ­with ­dermo-epi­dermic ­grafts ­according to ­Reverdin and in 1 ­case ­with curet­tage of the ­ulcer.
­Results. Com­plete ­cure was ­obtained in all ­cases ­with a 100% suc­cess ­rate for the ­dermo-epi­dermic ­grafts.
Con­clu­sions. Iso­lated insuf­fi­ciency of the ­short saph­e­nous ­vein is a ­clear-cut path­o­log­ical ­entity ­which can ­lead to ulcer­a­tion in a sub­stan­tial ­number of ­cases. The ­results ­obtained sug­gest ­that com­bined sur­gical ­therapy—strip­ping of the ­short saph­e­nous and ­dermo-epi­dermic ­grafts ­according to ­Reverdin—is the ­best solu­tion for a ­rapid and effec­tive solu­tion of ­venous ­ulcers.

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