The Turkish Journal of Vascular Surgery
Yazarlar: Esin Derin Çiçek, Hasan Murat Arslan
Konular:-
Anahtar Kelimeler:Doppler ultrasound,Focal valvular incompetence,Great saphenous vein,Venocuff™
Özet: Objectives: This study aims to assess the efficacy of external valvuloplasty with silicone stents in the management of isolated terminal or preterminal valve dysfunction at the saphenofemoral junction based on comparisons between pre- and postoperative findings on Doppler ultrasound of the lower limbs. Patients and methods: This study included a total of 16 female patients (mean age 44.1±7.6 years; range, 32 to 58 years) who underwent valvuloplasty with the Dacron®-reinforced silicone cuff (Venocuff II™ Venous Valve Exostent) for the treatment of focal superficial venous insufficiency between April 2014 and September 2018. Postoperative color Doppler ultrasonography (CDUS) findings at three to six months were retrospectively compared to preoperative CDUS findings to analyze the efficacy of the surgical technique. Preoperative measurements of the diameter (in mm) of the great saphenous vein and reflux time at the saphenofemoral junction were compared to postoperative measurements. Valvular incompetence was graded 0 to 4 based on the reflux time. All assessments were performed with a 7.5 MHz superficial vascular probe on an CDUS scanner. Clinical improvement was assessed based on the revised Venous Clinical Severity Score (VCSS). Results: The grade of great saphenous vein reflux was significantly lower after surgery compared to the reflux grade measured before surgery. A statistically significant decrease was detected in the mean diameter of the great saphenous vein (p<0.05), and the VCSS decreased statistically significantly after surgery. Conclusion: The Venocuff™ procedure is an effective surgical option which can reduce future complications by alleviating venous insufficiency. Moreover, patients may feel more comfortable with the procedure compared to other surgical modalities. Venous CDUS is of paramount importance for the diagnosis of isolated venous valvular insufficiency, as well as for the follow-up of patients after surgery.