PMID- 25723685
OWN - NLM
STAT- MEDLINE
DCOM- 20150422
LR  - 20240324
IS  - 1478-7083 (Electronic)
IS  - 0035-8843 (Print)
IS  - 0035-8843 (Linking)
VI  - 97
IP  - 2
DP  - 2015 Mar
TI  - Neovascularisation is not an innocent bystander in recurrence after great 
      saphenous vein surgery.
PG  - 102-8
LID - 10.1308/003588414X14055925061199 [doi]
AB  - INTRODUCTION: This study sought to establish the causes of failure of great 
      saphenous vein surgery among patients in whom there was confidence that accurate 
      saphenofemoral ligation had been carried and the great saphenous vein had been 
      stripped at least to knee level. METHODS: This was an observational study of 100 
      limbs (66 patients) operated on by a single surgeon 5-22 years previously (mean: 
      12 years). The index operation was primary in 54 limbs and for recurrence in 46 
      limbs. Thirty-two patients were studied having been re-referred for recurrence 
      while 34 were recalled for review. All were examined clinically and with duplex 
      ultrasonography, and all completed questionnaires (Aberdeen varicose vein 
      questionnaire [AVVQ] and EQ-5D-3L). In order to measure the extent of visible 
      recurrence, a scoring system similar to that in the venous clinical severity 
      score was used but with a range of 0-8. RESULTS: There were visible varicosities 
      in 77 of the 100 limbs. Duplex ultrasonography showed that recurrent 
      saphenofemoral incompetence (SFI) was present in 27% of the limbs. This was 
      judged to result from neovascularisation and was the most common source of 
      reflux. AVVQ scores for the 27 limbs with recurrent SFI (median: 34, 
      interquartile range [IQR]: 20-42) were higher than for the 73 with no recurrent 
      SFI (median: 17, IQR: 11-29), which was a significant difference (Mann-Whitney U 
      test, p<0.01). Analysing clinical scores with chi-squared tests indicated fewer 
      visible varicosities in limbs without recurrent SFI than in those with recurrent 
      SFI (p<0.01). CONCLUSIONS: Neovascularisation remains poorly understood but it 
      cannot be considered an innocent bystander.
FAU - Corbett, C R R
AU  - Corbett CR
AD  - Brighton and Sussex University Hospitals NHS Trust, UK.
FAU - Prakash, V
AU  - Prakash V
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Ann R Coll Surg Engl
JT  - Annals of the Royal College of Surgeons of England
JID - 7506860
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neovascularization, Pathologic/*complications/diagnostic imaging
MH  - Obesity/complications
MH  - Recurrence
MH  - Reoperation
MH  - Saphenous Vein/diagnostic imaging/*surgery
MH  - Ultrasonography, Doppler, Duplex
MH  - Varicose Veins/*surgery
MH  - Venous Insufficiency/complications
PMC - PMC4473385
EDAT- 2015/02/28 06:00
MHDA- 2015/04/23 06:00
PMCR- 2016/03/01
CRDT- 2015/02/28 06:00
PHST- 2015/02/28 06:00 [entrez]
PHST- 2015/02/28 06:00 [pubmed]
PHST- 2015/04/23 06:00 [medline]
PHST- 2016/03/01 00:00 [pmc-release]
AID - 061199 [pii]
AID - 10.1308/003588414X14055925061199 [doi]
PST - ppublish
SO  - Ann R Coll Surg Engl. 2015 Mar;97(2):102-8. doi: 
      10.1308/003588414X14055925061199.