Functional assessment of primary lesion of the great saphenous vein when deciding upon stripping

Tsukanov Yu.T., Tsukanov A.Yu.

Omsk State Medical University under the Ministry of Public Health of the Russian Federation, Omsk, Russia

The purpose of the study was to examine a possibility of functional assessment of the great saphenous vein (GSV) with the help of a day orthostatic loading test for prognosis of restoration of the function of the GSV afterremoving its varicose tributaries in patients with primary varicose veins.

Our prospective study included a total of sixty-five 29-to-53-year-old patients (15 men and 50 women, mean age – 36.7 years). The total number of the lower limb examined amounted to 87.

All patients underwent ultrasonographic examination (duplex scanning) prior to operation, 1 and 12 months thereafter. The study was carried out using a day orthostatic loading test consisting in duplex scanning performed twice during 24 hours: in the evening after 18:00 hours and in the morning before 10:00 hours after a good night’s rest. It was demonstrated that the day orthostatic loading test characterized the degree of preservation of the muscular-tonic properties of the GSV, making it possible to predict reversibility of reflux along it after removing the varicose tributaries, hence it may be used as a criterion for individualization of the choice of the scope of surgical intervention. A high orthostatic gradient prior to operation suggests preservation of the potential of the muscular-tonic function of the GSV; its decrease after surgery demonstrates reduction of the volemic loading on the GSV.

KEY WORDS: varicose veins, great saphenous vein, reflux, miniphlebectomy, stripping, day orthostatic loading test.

P. 120

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