Vaskulárna medicína 1-2/2012
Varicose veins – facts, prejudices, superstitions
The aim of this paper is to discuss some prejudices and superstitions which are persisting in treatment of varicose veins of lower extremities. During the period of 1993 – 2010 2460 extremities were operated; 481 (20%ň cases were reoperations. Total anaesthesia was used in 1881 (76%) subjects, (one-day surgery, in-patient). 579 (24%) underwent procedures under local anaesthesia (one day surgery,out-patient). Crossectomy with resection of all tributaries was obligatory, most including invagination stripping of the femoral part of the great saphenous vein (GSV). When necessary, the saphenopopliteal junction, perforators and hugh varicose were resected. No death recorded, the complications rate was 3 % - mostly wound complications. 95% of patients were discharged immediately or a few hours after the procedure. Over 50% of patients were not out of work. Authors comment a common prejudice, that drugs can heal the varicose veins. Fact is, that some drugs can moderate some signs of chronic venous insufficiency in some cases. With regard to expensivity of this treatment,a physician should consider, if the treatment is profitable for the patient, or only handy for the pharmaceutical company. More hazardous for the patient is next prejudice, that the secondary varicose veins should not be operated because the deep venous system damage. But, superficial veins,even varicose,can not be collateral to damaged deep veins. The more serious the damage is, and the more digger the secondary varicose veins are, the more acute is need of operation of varicosee veins. When not done, the patient is sentenced to leg ulcer. About neovascularisation: Authors operated 324 patients for a recurrent reflux in groin after classic operation performed in another hospital. In all of this 324 cases authors found technical fault in groin as cause of recurrence of saphenofemoral reflux. Neovascularisation as the cause of recurrence simply was not recorded.
Keywords: varicose veins, one day surgery.
