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A Journal on Vascular and Endovascular Surgery
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
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.