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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2014 Dicembre;33(6):547-52

lingua: Inglese

Cryosclerosis. A forgotten endovenous procedure for treating the incompetence of the great saphenous vein. Short term results

Balint I. B. 1, Vizsy L. 1, Vargovics E. 2, Farics A. 1, Parti K. 1, Simon E. 1

1 Department of Surgery, Kanizsai Dorottya Hospital, Hospital of Nagykanizsa, Nagykanizsa, Hungary;
2 Department of Radiology, Kanizsai Dorottya Hospital, Hospital of Nagykanizsa, Nagykanizsa, Hungary


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AIM: The aim of the present study was to prove the effectiveness, reliability and minimal invasiveness of cryosclerosis.
METHODS: A prospective non-randomized study had been performed. The study enrolled 96 patients; 48 patients were treated by cryosclerosis and the other 48 by conventional stripping. Every time high ligation and phlebectomy of varices were done, in 1 patient the incompentence of the small saphenous vein was treated also by cryosclerosis. During the follow-up visits the obliteration of the great saphenous saphenous vein (GSV) was investigated; as primary objective of the study, secondary outcome measures were the most frequent complications of the conventional surgery, postoperative pain and recovery. Color-Duplex scan of the operated lower extremity was performed into 30 patients of the study group. Additionally, the vein wall (unhandled and frozen) was analyzed by transmission electron microscope in one case. All of the involved patients were examined at a follow-up visit (7 days after surgery) and sent back a questionnaire (6-8 weeks after surgery).
RESULTS: Recanalization was observed only in 2 patients (success rate after 6 weeks: 93.3%). Thromboembolic events occurred only in the control group (1 patient, minor pulmonary embolism). Regarding mild wound healing disorder and lymphorrhea there were no significant differences between the groups. Concerning postoperative pain, bruising and recovery the cryosclerosis was found significantly favorable. The incidence of limb swelling after surgery was the same in each group. Temporary sensory abnormalities seem to be frequent in the study group, but the results show that the rate of permanent saphenous nerve injury is higher in the patients operated with the conventional method. The histological examination showed changes in the frozen vein wall.
CONCLUSION: Lacking long-term results, we can only consider that cryosclerosis allows the occlusion of the great saphenous vein, is minimal invasive and should be considered among endovenous procedures for treating GSV incompetence.

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balint_istvan_bence@yahoo.com