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Dedicated to improving the treatment of venous disease

Volume 8, Number 10

www.venousdigest.com

October 2001

Copyright 1995 John J. Bergan, MD, Inc.

1 of 7

Venous Digest, 2329 Barley Drive, Vista, CA 92083 USA (760) 599-9725

TREATMENT OF VARICOSE VEINS:

PROXIMAL SAPHENOFEMORAL

LIGATION COMPARING ADJUNCTIVE

VARICOSE PHLEBECTOMY WITH

SCLEROTHERAPY

AT A MILITARY

MEDICAL CENTER

Brethauer SA, Murray JD, Hatter DG et al.

Vasc Surg 2001; 35:51-58

ABSTRACT AND COMMENTARY BY:

C. Vaughan Ruckley, MB, ChM, FRCSE

University of Edinburgh

Edinburgh, Scotland

The authors seek a system of managing varicose veins that

facilitates a rapid return to activity duty for military personnel.

They report a consecutive series of 103 patients treated for

saphenofemoral ligation combined with point perforator ligation

and stab avulsion (AP group) for primary varicose veins. They

had previously reported a series of 104 patients who underwent

saphenofemoral ligation followed by staged sclerotherapy (SC

group). The current paper compares the two series.

The authors do not indicate whether the operating surgeons

and the surgical technique were the same in the two series.

Surgical complications did not differ between the two series.

Intraoperative pain was the most common complaint in the AP

group but the figure for the SC group is not mentioned. Most

patients in the AP group returned to work in three days but the

corresponding figure for the SC group is not given. In the AP

group, there was a 74% followup (mean duration 418 days,

range 123 to 755). Followup in the SC group was a mean of

387 days (range 150 to 715) but the percentage of followup was

not given. Recurrence rates were 11% and 12%, respectively

with nine patients crossing over from AP to SC. In the AP

group, therapy was completed in a mean of 2½ days compared

with 70 days in the SC group. There was no difference in

patient satisfaction. For practical reasons, the authors have

adopted ambulatory phlebectomy (AP) rather than adjunctive

sclerotherapy (SC) as their procedure of choice.

COMMENTARY

Lack of clinical trial format, omission of comparative data,

and relatively short mean followup limit the value of this study.

TABLE OF CONTENTS

Treatment of Varicose Veins: Proximal Saphenofemoral Ligation

Comparing Adjunctive Varicose Phlebectomy with Sclerotherapy at a

Military Medical Center

Brethauer SA, Murray JD, Hatter DG, et. al.

Abstracted by: C. Vaughan Ruckley, Edinburgh, Scotland

The Relationship Between the Number, Competence, and Diameter of

Medial Calf Perforating Veins and the Clinical Status in Healthy

Subjects and Patients with Lower Limb Venous Disease

Stuart WP, Adam DJ, Allen PL, et. al.

Abstracted by: Ermengildo Enrici, Buenos Aires, Argentina

Saphenous Surgery Does Not Correct Perforator Incompetence in the

Presence of Deep Venous Reflux

Stuart WP, Adam DJ, Allen PL. et. al.

Abstracted by: Ermengildo Enrici, Buenos Aires, Argentina

A Color Doppler Ultrasound Study of Venous Reflux in Patients with

Chronic Leg Ulcers

Magnusson MB, Nelzen O., Risberg B, Sivertsson R.

Abstracted by: G. Mark Malouf, Sydney, Australia

The Impact of Isolated Lesser Saphenous Vein System Incompetence

on Clinical Signs and Symptoms of Chronic Venous Disease

Labropoulos N, Giannoukas AD, Delis K, et. al.

Abstracted by: Csaba Dzsinich, Budapest, Hungary

Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins:

3

rd

Edition

Book Review by Warner Bundens, San Diego, California, USA

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