Pathogenesis and etiology of recurrent varicose veins

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Presentation transcript:

Pathogenesis and etiology of recurrent varicose veins Maresa Brake, MBBS, BSc, Chung S. Lim, MRCS, PhD, Amanda C. Shepherd, MRCS, MD, Joseph Shalhoub, MRCS, PhD, Alun H. Davies, DM, FRCS Journal of Vascular Surgery Volume 57, Issue 3, Pages 860-868 (March 2013) DOI: 10.1016/j.jvs.2012.10.102 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. Journal of Vascular Surgery 2013 57, 860-868DOI: (10.1016/j.jvs.2012.10.102) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 The factors involved in the pathogenesis of true recurrence of varicose veins. The postulated factors contributing to true varicose vein recurrence may broadly be divided into two groups: intraoperative factors (A) and postoperative factors (B). CFV, Common femoral vein; GSV, great saphenous vein; SFJ, saphenofemoral junction. Journal of Vascular Surgery 2013 57, 860-868DOI: (10.1016/j.jvs.2012.10.102) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Neovascularization (blue and red) around a previously ligated saphenofemoral junction of a patient with recurrent varicosities on color duplex ultrasonography. Journal of Vascular Surgery 2013 57, 860-868DOI: (10.1016/j.jvs.2012.10.102) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 4 Resin casts of recurrent refluxing saphenofemoral junction specimens. Following injection of resin from the saphenofemoral junction, a tortuous network of vessels is visualized. There is a variation in size and abundance of vessels when comparing both specimens (A and B). The direction of the neovascularization channels was noted to be outward from the stump toward the subcutaneous tissue. A, Several larger channels are accompanied by many much smaller channels running in a proximal to distal direction. B, This cast is dominated by three large-diameter tortuous channels, with a number of small channels present in continuity. Scale bars: (A) 5 mm; (B) 10 mm. (This image has been reproduced with permission from the Journal of Vascular Surgery.)41 Journal of Vascular Surgery 2013 57, 860-868DOI: (10.1016/j.jvs.2012.10.102) Copyright © 2013 Society for Vascular Surgery Terms and Conditions