Varicose veins: new trends in treatment in a Vascular Surgery Unit

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COD: 09_1222_2490 Categorie: ,

Daniela P. Mazzaccaro, Silvia Stegher, Maria Teresa Occhiuto, Lorenzo Muzzarelli, Giovanni Malacrida, Giovanni Nano

Ann. Ital. Chir., 2016 87: 166-171

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AIM: Less invasive techniques such as foam sclerotherapy, endovenous laser or radiofrequency ablation have recently been
introduced as a valid alternative to surgery for the treatment of varicose veins (VVs). We retrospectively reviewed our
experience in the treatment of VVs with particular attention to how our therapeutic approach has changed over the last
years.
MATERIAL OF STUDY: Data of all patients consecutively treated from September 1st 2013 to July 31st 2015 for both
primitive and recurrent VVs were retrospectively collected and analyzed. Statistical analysis was performed using the software
JMP 5.1.2 (SAS Institute).
RESULTS: A total of 409 legs in 378 patients were treated. The percentage of stripping of the great saphenous veins
(GSV) for primary VVs has decreased over the years (67% in 2013 vs 15.2% in 2015), differently from what happened
to the percentage of RFA of the GSV (14.3% vs. 31.5% respectively in 2013 and in 2015) and to the percentage
of legs treated with the A.S.V.A.L. technique (8.7% vs. 31.5% respectively in 2013 and in 2015). Likewise,
in 2013 most procedures were performed using spinal anesthesia (77.5%), while in 2015 the most used anesthetic techniques
were both the local anesthesia and the local anesthesia with conscious sedation (35.9% and 29.3% respectively).
Postoperative course was uneventful in all cases but seven (1.7%). At follow-up (median 16.9 months, IQR 7.5-22.6
months), neither major adverse events nor deaths were recorded.
CONCLUSIONS: During the years of our experience, we observed a trend towards a less invasive approach for the treatment
of VVs, with safe and effective results.

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