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Introduction. Acute varicothrombophlebitis is one of the most common and dangerous complications of varicose veins of the lower extremities, as it is a common cause of deep vein thrombosis and pulmonary embolism. It develops in 30-60% of patients with varicose veins. Methods. The evaluation of early and long-term results of surgical treatment of acute varicothrombophlebitis in 234 patients with acute varicothrombophlebitis in the basin of the great saphenous vein was performed. Results. Depending on the prevalence of thrombotic process in the basin of the great saphenous vein, patients were divided into the following groups: Group I – inflow varicothrombophlebitis (n = 23 (9.8%); Group II – varicothrombophlebitis of the shin (n = 51 (21.8%); Group III – varicothrombophlebitis of the thigh (n = 21 (9.0%); Group IV – total varicothrombophlebitis (n = 27 (11.6%); Group V – ascending varicothrombophlebitis (n = 67 (28.6%); VI group – transfascial thrombosis (n = 45 (19.2%). Conclusions. Surgical treatment of acute varicothrombophlebitis of the lower extremities according to the cumulative analysis allowed to achieve a positive treatment result in 94.5% of patients. Recurrence of thrombosis in the early and distant postoperative period was observed in 0.5% and 2.2%, respectively.

The objective of the research was to improve the diagnostics and treatment of patients with primary varicose great saphenous veins by studying their frequency and systematizing the variants of localization and extension of great saphenous vein hypoplasia and aplasia in its trunk. Materials and Methods. The study included 560 patients with varicose veins of the lower limbs and pathological refluxes in different segments of the great saphenous vein. All the patients underwent triplex ultrasound scan of the lower limb venous system. Results. Among the patients with pathological reflux in a certain GSV segment, hypo- and aplasia of its segments were observed in 32.5% of the cases (95% CI 28.6-36.6%). Aplasia of this vein was observed twice as less frequently than hypoplasia (p<0.05). In 2.3% of the cases (95% CI 1.2-3.9%), hypoplasia of a certain GSV segment evolved to aplasia, or vice versa. It was found that the GSV trunk may have several hypo- or aplastic regions separated by its normal or varicose segment – bi-level hypo- or aplasia that was observed in 3.8% of the patients with hypo- or aplasia (95% CI 1.6-7.8%). In bi-level hypo- or aplasia, 2 hypoplastic regions were detected in 85.7% of the cases (95% CI 42.1-99.6%) and 2 aplastic regions were found in 14.3% of the cases (95% CI 0.4-57.9%). There were proposed to distinguish the following variants of GSV hypo- and aplasia: 1) simple: total, proximal, segmental and distal; 2) bi-level: proximal segmental, distal segmental and bi-segmental. In addition, for every dysplastic vein segment, the type of malformation should be indicated, namely hypoplasia, aplasia, or hypo/aplasia. Conclusions. The study conducted allowed assessing the relationship between the variants of GSV hypo- and aplastic segment localization and extension and different variations of pathological refluxes of the GSV in its trunk for further choice of surgical tactics.

Peripheral arterial occlusive disease has a high prevalence worldwide, as well as in our population, and contributes to an immense burden of morbidity and mortality. Due to the systemic nature of especially atherosclerotic vascular disease, most patients also have cardiovascular and cerebrovascular involvement at the time of presentation, adding to the huge impact on the patient and the economy. Lower limb amputation is associated with a 50% 5-year mortality rate, thus peripheral arterial disease itself is also responsible for considerable mortality rates. Attempting to re-establish perfusion to an ischaemic limb is crucial in saving the limb and the life of the patient. Options for revascularisation of patients with limb-threatening ischaemia include open and endovascular approaches, each with its own indications and shortcomings. In the case of open infra-inguinal bypass grafting, the great saphenous vein is the preferred conduit used to replace the diseased segment. It has been proven to perform superiorly to synthetic grafts with respect to long-term patency, adequate length, and swift harvesting. This vein is also used in other autogenous bypass procedures, including coronary bypass graft surgery and arterio-venous fistula grafts for access in renal replacement therapy. Occlusion of the graft, or graft-failure, is one of the dreaded complications of any bypass procedure, and can be divided into primary or secondary failure, according to the time from procedure to the establishment of the diagnosis. Both scenarios are detrimental to the salvage rate of the limb, and can also indirectly contribute to the demise of the patient. Many factors have been associated with primary graft failure, particularly the size of the conduit graft, which was the main focus of our study. Our primary aim was to determine the average great saphenous vein size in our study population, and our secondary aim was to demonstrate a relationship between vein size and demographic variables l

OBJECTIVE: To describe and evaluate feasibility and efficacy of a saphenous ablation technique performed in patients with varicose veins (VVs), great saphenous vein (GSV) incompetence, and proximal femoral valve incompetence: the Excluded Saphenous Vein Technique (ESVT).PATIENTS AND METHODS: Patients with primary great saphenous and proximal femoral valve incompetence underwent ESVT. This technique is composed of selective crossectomy, GSV ligation next to the thigh incompetent tributary vein, and saphenous vein sclerosing performed from the proximal zone. Demographic. clinical and instrumental data were collected. CEAP classification was used to describe VVs severity. The primary outcome was perioperative complications. Secondary outcomes were 30-days. 6-months and 1-years GSV occlusion rate. and VVs recurrence rate.RESULTS: During a ten months period, 104 patients were analyzed. Among these, 82 patients underwent ESVT (59 female. age 50 +/- 21 years), eighty C2 and two C5, according to CEAP classification. The average length of GSV treated was 23 +/- 9 cm. No intraoperative complications occurred. A 1-year follow-up analysis revealed no partial or complete saphenous recanalization, deep venous thrombosis, pulmonary embolism. No VVs recurrence was detected during the follow-up period among the entire population.CONCLUSIONS: ESVT seems to be a safe and effective treatment for primary saphenous reflux and proximal femoral valve incompetence. Further studies are needed to assess long-term results.

Laser has become a useful technology in treating venous incompetence especially superficial venous disease. Introduction of endovenous thermal ablation through endovenous laser therapy helped by duplex ultrasound guidance has provided an alternative for traditional saphenous vein stripping. High success rate, minor complications, and minimally invasive technique provide the advantages over traditional treatment. In this case illustrated, the endovenous laser therapy used for great saphenous varicose vein. Yet, future development in endovenous laser therapy is still needed and only long term follow-up and uniform reporting standards will provide the answers. (Med J Indones. 2013;22:117-20)