The Changes And Clinical Significance Of Deep Venous Valve Function After Superficial Vein Surgery For Varicose Veins Of Lower Extremity

Background: The Varicose veins of lower extremity is a kind of common disease of vascular surgery, it is generally accepted that deep venous insufficiency is the primary cause of varicose veins of lower extremity. The clinical confirmation that various kinds of vavuloplasty of deep vein for improving deep venous valve function are valid treatment ways is accepted, but there are big wound and more complications generally. Many scholars have discovered when superficial and deep venous reflux are exist simultaneity, merely eliminating gravitational reflux by proximal saphenous vein ligation and ablation of varicose veins can eliminate deep reflux that improved deep venous function and allowed alleviate suffering of patients. The phenomenon hint that we should not only confirm if the surgical method could improve the function of deep venous, but also discuss how the operation can improve extension of deep venous valve function. Endovenous laser treatment is a mini-traumatic operation for varicose veins of lower extremity in recent years, but the report whether it have effectiveness for deep venous valve function haven't been seen yet.Object: To evaluate improved effect for deep venous valve function between endovenous laser treatment and proximal saphenous vein ligation and ablation of varicose veins, and explore possible mechanisms and improved extent whether there are differences in improving deep venous hemodynamics. To observe how superficial vein surgery can improve the function of deep venous valve, exploring influential factors why there is no or a little improvement, which could make the doctor know the prognosis of them is dissatisfied by superficial vein surgery before operation, so should do an external vavuloplasty to their deep veins.Methods: 60(70 limbs) patients with Varicose veins of lower extremity were enrolled to accept surgical management of vein systems. All patients were randomized into two groups respectively according to the operating style. The laser group was given proximal saphenous vein ligation before the wall of greater saphenous vein was treated with power of laser, to occlude the whole length of the vein and other collaterals; the stripping group was given proximal saphenous vein ligation and ablation of varicose veins. Both groups of each patient were detected with color Doppler ultrasonography, their deep venous hemodynamics index was measured and recorded before operation. The effect was compared between both groups of each patient and two groups by color duplex scanning three month after operation.Results: The index of deep venous hemodynamics of the two groups have prominent improvement after operation, the improvement for deep reflux have no significant difference between the two surgical methods. The valve function of superficial femoral vein and popliteal vein are improved after operation, and there is no significant difference between the two veins in effectiveness.Conclusion: Both surgical methods are effective for Varicose veins of lower extremity, and it is confirmed that they can improve deep vein valve function in some extent. The principle may be proximal saphenous vein ligation and major stem obliteration can eliminate gravitational reflux, so preventing elongation and dilatation of major deep veins and allowing the valve to close well. Superficial operation in time while appearing Varicose veins of lower extremity may defer the deep venous insufficiency. To those patients with axial reflux, the course of this disease is longer than 20 years and age is older than 60 years in Preoperative examination, the doctor should know the prognosis of them is dissatisfied by superficial vein surgery before operation, so should do an external vavuloplasty to their deep veins. .