TECHNICAL NOTES   

International Angiology 1999 December;18(4):343-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Surgical management of ascending saphenous thrombophlebitis

Murgia A. P., Cisno C., Pansini G. C., Manfredini R., Liboni A., Zamboni P.

From the Department of Surgery and Vascular Laboratory, University of Ferrara, Ferrara, Italy

Background. Acute saph­e­nous vein ascend­ing throm­boph­le­bitis is rec­og­nised to be a dan­ger­ous con­di­tion due to the report­ed high inci­dence of deep vein throm­bus involve­ment and pos­sibly fatal pul­mo­nary embo­lism. We ­assessed the accu­ra­cy of ­duplex scan­ning in deter­min­ing the ­extent of throm­bo­sis as well as the effec­tive­ness of sur­gi­cal treat­ment.
Methods. We ret­ro­spec­tive­ly ­reviewed 146 ­patients ­referred to our Vas­cu­lar Labor­a­to­ry for acute super­fi­cial throm­boph­le­bitis from 1987 to 1997. Duplex scan­ning iden­ti­fied 85 cases of super­fi­cial throm­boph­le­bitis involv­ing at least a seg­ment of the saph­e­nous vein loc­al­ised below the knee (58.2%); 37 of throm­boph­le­bitis extend­ing into both the super­fi­cial and deep ­venous ­systems (25.3%), and 24 of saph­e­nous throm­bo­sis extend­ing to with­in 5 cm of the saph­e­nof­e­mo­ral junc­tion (16.4%). The lat­ter group under­went saph­e­nof­e­mo­ral dis­con­nec­tion. We com­pared the pre­op­er­a­tive ­duplex with the sur­gi­cal ­reports and eval­u­at­ed the sur­gi­cal ­results.
Results. We did not ­observe any com­pli­ca­tion. Return to work and nor­mal activ­ity ­occurred with­in 3-5 days. When var­i­cose vein throm­bec­to­my was per­formed con­cur­rent­ly, the ­patients had bet­ter post­op­er­a­tive pain con­trol.
Conclusions. Duplex scan­ning ­showed 100% accu­ra­cy both in deter­min­ing the pres­ence of throm­bo­sis and its ­extent. Saphenofemoral dis­con­nec­tion for throm­bo­sis involv­ing the saph­e­nof­e­mo­ral junc­tion is a safe pro­ce­dure and can be per­formed on an out­pa­tient basis.