Therefore, surgical excision of VVs with ligation and stripping of the great or superficial
saphenous vein remains the current standard surgical treatment method in cases with involvement of the great or small
saphenous veins (26).
The Society for Vascular Surgery and the American Venous Forum both recommend that thermal ablation (EVLA or RFA) is a safe and effective method for the treatment of incompetent
saphenous veins. US-guided foam sclerotherapy, bipolar radiofrequency (RF) ablation, cryostripping, and EVLA, are all less invasive methods compared with surgery.8 These modalities have a lower morbidity and recurrence rate as opposed to surgery, and their use is on the rise.
"When radial artery grafts were used, the bypasses stayed open longer, and patients were significantly less likely to suffer a heart attack or need another revascularization than when the
saphenous vein was used," says Cleveland Clinic heart surgeon Faisal Bakaeen, MD.
Reflux in
saphenous veins. Longitudinal view and spectral Doppler imaging show significant reflux in the great
saphenous vein at the level of distal thirds of the thigh following a Valsalva's maneuver (a).
Despite the long-term outcomes superiority of the arterial grafts, autologous venous vessels, such as the
saphenous vein, remains an important option for bypass surgery due to the ease of obtaining and the abundant collateral circulation (Petrofski et al., 2004).
To accomplish this goal surgery of the great
saphenous vein, the short
saphenous vein and/or surgery of the perforator veins was performed.
Moll, "Five-year results of a randomised clinical trial of endovenous laser ablation of the great
saphenous vein with and without ligation of the saphenofemoral junction," European Journal of Vascular and Endovascular Surgery, vol.
Many techniques have been reported to reduce postoperative lymphedema, such as preserving the muscle fascia [3], pedicled omentoplasty [4], sartorius transposition [5], and
saphenous vein sparing inguinal lymphadenectomy [6].
The authors suggest supplementing supine chest radiographs with contrast or ultrasound when the line tip position is unclear, and that supine and lateral abdominal radiographs are useful to ensure placement in the inferior vena cava when placing a PICC in the
saphenous vein of a neonate.
The team removed all cells from sections of human
saphenous veins, which left a tube consisting only of the protein scaffolding that supported the cells.
Successful treatment of both the great and small
saphenous veins and long-term maintenance of vein closure are the norm, with rates ranging from 88% to 100% for both RFA (13,14) and ELT, regardless of vein size.