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Dedicated to improving the treatment of venous disease

Volume 8, Number 12

www.venousdigest.com

December 2001

? 1995 John J. Bergan, MD, Inc. Page 1 Venous Digest, 2329 Barley Drive, Vista, CA 92083 USA (760) 599-9725

SCLEROTHERAPY WITH LIGATION OF

INCOMPETENT VEINS FOR A STASIS

ULCER DUE TO VARIX CRURIS:

MINIMAL INVASIVE THERAPY FOR

VARIX CRURIS

Takeda Y, Agui T, Tanaka K, Okuzawa M, Tanigawa N.

Jpn J Surg 1999; 29:1154-57

ABSTRACT AND COMMENTARY BY:

Prof. dr. hab. med. Mieczyslaw Szotstek

Warszawa, Poland

EDITOR'S NOTE

This article was chosen for this issue of the Venous Digest

because it presents one point of view from Japan. There are too

few Japanese publications that can be selected by us for

abstracting and commentary, and this one does present an

interesting point of view even though the methods are probably

superannuated.

ABSTRACT

Sclerotherapy combined with ligation of incompetent greater

saphenous, lesser saphenous, or perforating veins is considered a

potential alternative to the traditional surgical treatment for varix

cruris although it still remains controversial.

The authors started performing sclerotherapy with ligation of

incompetent veins for varix cruris in 1991. A retrospective

analysis was performed on 11 patients with a stasis ulcer due to

varix cruris who underwent sclerotherapy with ligation of

incompetent veins. Preoperative phlebography revealed no

evidence of deep venous thrombosis. Five of the 11 patients had

incompetent perforating veins proven by palpation and Doppler

study. Suprafascial ligation of those incompetent perforating

veins at the point of blowout was performed and then sclerosant

was injected into the varicose veins. Points of ligation were

marked and included: 1) The greater saphenous vein at the

saphenofemoral junction and above the knee when reflux was

audible along the greater saphenous vein; 2) the lesser saphenous

vein at the saphenopopliteal junction when reflux was audible

along the lesser saphenous vein; and 3) the incompetent

perforating veins at the blowout when reflux was confirmed by

bulging at the fascial defect on physical examination and reflux

sound on Doppler.

TABLE OF CONTENTS

Sclerotherapy with Ligation of Incompetent Veins for a Stasis Ulcer

Due to Varix Cruris: Minimal Invasive Therapy for Varix Cruris

Takeda Y, Agui T, Tanaka K, et. al.

Abstracted by: Mieczyslaw Szotstek, Warsaw, Poland

Surgical Removal of Ulcer and Lipodermatosclerosis Followed by

Split-Skin Grafting (Shave Therapy) Yields Good Long-Term Results

in ?Non-Healing? Venous Leg Ulcers

Schmeller W, Gaber Y.

Abstracted by: Massimo D?Addato, Bologna, Italy

A Multicenter Study of Percentage Change in Venous Leg Ulcer Area

as a Prognostic Index of Healing at 24 Weeks

Kantor J, Margolis DJ.

Abstracted by: Enrique Ona, R. Quintos, Manila, Philippines

Does Surgical Correction of the Superficial Femoral Vein Change the

Course of Varicose Disease.

Makarova RP, Lurie F, Helniker SM.

Abstracted by: Lars Norgren, Malm?, Sweden

Lipodermatosclerosis is Characterized by Elevated Expression and

Activation of Matrix Metalloproteinase: Implications for Venous

Ulcer Fomation

Herouy Y, May AE, Pronschlegel G, et. al.

Abstracted by: Fedor Lurie, Honolulu, Hawaii

Changes in Metalloproteinase (MMP-1, MMP-2) Expression in the

Proximal Region of the Varicose Saphenous Wall in Young Subjects

Buhan J, Jurado F, Gimeno MJ, et al.

Abstracted by: Geert Schmid-Sch?nbein, La Jolla, California

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