Clinical, ultrasonographic and histological findings in varicose vein surgery

Rev Assoc Med Bras (1992). 2018 Aug;64(8):729-735. doi: 10.1590/1806-9282.64.08.729.

Abstract

Objective: This study aims to correlate the demographic data, different clinical degrees of chronic venous insufficiency (CEAP), ultrasound findings of saphenofemoral junction (SFJ) reflux, and anatomopathological findings of the proximal segment of the great saphenous vein (GSV) extracted from patients with primary chronic venous insufficiency (CVI) submitted to stripping of the great saphenous vein for the treatment of lower limb varicose.

Method: This is a prospective study of 84 patients (110 limbs) who were submitted to the stripping of the great saphenous vein for the treatment of varicose veins of the lower limbs, who were evaluated for CEAP clinical classification, the presence of reflux at the SFJ with Doppler ultrasonography, and histopathological changes. We study the relationship between the histopathological findings of the proximal GSV withdrawal of patients with CVI with a normal GSV control group from cadavers.

Results: The mean age of the patients was higher in the advanced CEAPS categories when comparing C2 (46,1 years) with C4 (55,7 years) and C5-6(66 years), as well as C3 patients (50,6 years) with C5-6 patients. The normal GSV wall thickness (mean 839,7 micrometers) was significantly lower than in the saphenous varicose vein (mean 1609,7 micrometers). The correlational analysis of reflux in SFJ with clinical classification or histopathological finding did not show statistically significant findings.

Conclusions: The greater the age, the greater the clinical severity of the patients. The GSV wall is thicker in patients with lower limb varicose veins, but those histopathological changes are not correlated with the disease's clinical severity or reflux in the SFJ on a Doppler ultrasound.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Chronic Disease
  • Female
  • Femoral Vein / diagnostic imaging
  • Femoral Vein / pathology
  • Femoral Vein / surgery
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Saphenous Vein* / diagnostic imaging
  • Saphenous Vein* / pathology
  • Saphenous Vein* / surgery
  • Severity of Illness Index
  • Ultrasonography, Doppler, Color
  • Varicose Veins* / diagnostic imaging
  • Varicose Veins* / pathology
  • Varicose Veins* / surgery
  • Venous Insufficiency* / diagnostic imaging
  • Venous Insufficiency* / pathology
  • Venous Insufficiency* / surgery
  • Young Adult