J. Hammarsten et al., A STUDY OF THE MECHANISMS BY WHICH HEMODYNAMIC FUNCTION IMPROVES FOLLOWING LONG SAPHENOUS VEIN-SAVING SURGERY, Phlebology, 11(3), 1996, pp. 102-105
Objective: To study the mechanisms by which haemodynamic function impr
oves following long saphenous vein-saving surgery. Design: Cohort stud
y. Patients: Twenty patients, 14 women and six men, with primary varic
ose veins. Interventions: Varicose vein surgery by the long saphenous
vein-saving technique. Main outcome measures: Preoperative investigati
on by physical examination, strain-gauge plethysmography, phlebography
and measurements of the long saphenous vein diameter at four differen
t locations using high-resolution, real-time ultrasound. Three months
following vein-saving surgery, the patients were reassessed with physi
cal examination, strain-gauge plethysmography and measurements of the
long saphenous vein diameter. Results: AU patients but one showed exce
llent or good results following surgery. The preoperative diameter of
the long saphenous vein was reduced by 40% at four different levels in
the operated legs (p<0.01). The venous return time of the same legs i
ncreased 2.4 times (p<0.001). The decrease of the long saphenous vein
diameter correlated positively with the increase in venous return time
(t-50), (r=0.50, p=0.04). Conclusion: The results suggest that the de
velopment of incompetent perforators is an early major event in the fo
rmation of primary varicose veins. The results also suggest that the l
ong saphenous vein valvular incompetence in varicose veins is attribut
able to venous wall dilatation rather than degeneration of the valves.
The results support the hypothesis that the improvement in haemodynam
ic function following long saphenous vein-saving surgery is due, at le
ast partly, to a reduction of the long saphenous vein diameter, which
in turn tends to restore valvular competence.