SURGICAL TREATMENT OF TRUNCAL VEINS Stephen F. Daugherty, MD, FACS, RVT, RPhS.

Slides:

Advertisements

Similar presentations

Joint Hospital Surgical Grand Round 19th October 2013

Advertisements

Venous Insufficiency: Nuts and Bolts

Debate: Never Perform Thermal and Chemical Ablation in the Same Setting Ron Bush, MD, FACS Midwest Vein & Laser Center Dayton, OH.

International Vein Congress May 12-14, 2011 DISCLOSURE David L. Walrath, M.D., F.A.C.S., A.B.Ph., R.P.V.I I have no financial relationships to disclose.

Complicated Superficial Venous Disease Ron Bush, MD, FACS Midwest Vein & Laser Center Dayton, OH.

Endovenous Laser Therapy for Lower Limb Varicose Veins: intermediate outcomes of 800 limbs. Khalid AL-Ghamdi, MD Vascular Fellow, King Saud University.

Varicose Veins Core Surgical Trainees Vascular Teaching Day Kent and Canterbury Hospital 1st December 2009 Hasantha Thambawita SpR Vascular Surgery.

Lower Extremity Venous Disease: Peripheral Venous Insufficiency

Athanasios D. Giannoukas MD, MSc(Lond.), PhD(Lond.), FEBVS

Venous Reflux Disease and Current Treatment Modalities VN20-03-B 10/04.

Chronic Venous Disease Treatment - Part II Vein closure and rerouting of blood through normal veins with Ultrasound Guided Foam Sclerotherapy S. Lakhanpal.

Your Company Name Procedure Education DAVID DIMARCO MD.

New Treatment Options for Varicose Veins Minimally Invasive Techniques to Remove Varicose Veins Dr. Shannon D. Thomas FRACS Vascular, Endovascular and.

Gabriel Herscu, M.D. Washington Township Medical Foundation.

MANAGEMENT OF POST-ENDOVENOUS ABLATION VENOUS THROMBOSIS Stephen F. Daugherty, MD, FACS Clarksville, Tennessee, USA.

CASE PRESENTATION ADVANCED PHLEBOLOGY AND DEEP VEIN COURSE American College of Phlebology - November 15, 2012 Stephen F. Daugherty, MD, FACS, RVT, RPhS.

SURGICAL TREATMENT OF TRUNCAL VEINS Stephen F. Daugherty, MD, FACS, RVT, RPhS.

Combined techniques : How to ablate varices during endovenous surgery ? R.Milleret, D.Valean, M.Fodor.

Venous Disease.

Improving health care through accreditation AN UPDATE Stephen F. Daugherty, MD, FACS, RVT, RPhS.

Varicose vein surgery: a few medicolegal considerations Jon Ghosh SpR General / Vascular Surgery.

Minimally invasive treatment of varicose veins: Endovenous laser ablation (EVLA) Georgios Galanopoulos, Constantinos Lambidis International Journal of.

Peripheral Venous Reflux - When is Surgical Intervention Necessary?

VenaCure EVLT™ Procedure Education by Dr

Assistant Lecturer of Vascular Surgery, Zagazig University

Introduction Methods Results Conclusions

KTS and Marginal Vein Insufficiency: Treatment Options

Klippel Trenaunay Syndrome Case presentation

Treatment of recurrent varicose veins of the great saphenous vein by conventional surgery and endovenous laser ablation Laura van Groenendael, MD, J.

Open surgery for Varicose veins

Endovascular radiofrequency ablation: A novel treatment of venous insufficiency in Klippel-Trenaunay patients Krista Frasier, BS, RVT, Gary Giangola,

Microfoam ablation of the long saphenous vein

Systematic review and meta-analysis of randomized controlled trials evaluating long- term outcomes of endovenous management of lower extremity varicose.

Outcome of Ultrasound-guided Sclerotherapy for Varicose Veins: Medium-term Results Assessed by Ultrasound Surveillance K.A. Myers, D. Jolley, A. Clough,

Combined endovenous laser therapy and microphlebectomy in the treatment of varicose veins: Efficacy and complications of a large single-center experience

Georgios Galanopoulos, Constantinos Lambidis

Endovenous laser and echo-guided foam ablation in great saphenous vein reflux: one- year follow-up results Rodrigo Gonzalez-Zeh, MD, Ricardo Armisen,

Steven T Deak, MD, PhD, FACS Deak Vein NJ Clinic Somerset, NJ

Nick Morrison, MD, Diana L. Neuhardt, RVT, Charles R

Retrograde Injection Technique for Endovenous Chemical Ablation of Varicose Veins, A Case Study Steven T Deak, MD, PhD, FACS Hungarian Medical Association.

Ultrasound guided foam sclerotherapy of varicose veins

Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: First clinical experience Thomas Michael.

Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency Robert F. Merchant,

Barrie A. Price, MD, MS, FRCS, FCPhleb, Charmaine C

Defining the role of extended saphenofemoral junction ligation: A prospective comparative study James G. Chandler, MDa, Olivier Pichot, MDb, Carmine.

Retrograde Microfoam Ablation of Superficial Venous Insufficiency:

Endovenous Radiofrequency Ablation of an Incompetent Great Saphenous Vein in Patient with Venous Ulceration and Severe Coagulopathy: A Case Report A.

James S.T. Yao, MD, PhD Journal of Vascular Surgery

Endovascular radiofrequency ablation: A novel treatment of venous insufficiency in Klippel-Trenaunay patients Krista Frasier, BS, RVT, Gary Giangola,

SS13. Endovascular Treatment of Klippel-Trenaunay Syndrome

Endovenous therapies of lower extremity varicosities: A meta-analysis

Endovenous laser treatment of the small saphenous vein

Lowell S. Kabnick, MD Journal of Vascular Surgery

Midterm results of the surgical treatment of varices by phlebectomy with conservation of a refluxing saphenous vein Paul Pittaluga, MD, Sylvain Chastanet,

Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins Anke A.M. Biemans, MD, Michael Kockaert,

Retrograde Endovenous Microfoam Chemical Ablation of Varicose Veins and Venous Valvular Reflux in CEAP 6 Ulcers Steven T Deak, MD, PhD, FACS VEITHsymposium.

Barrie A. Price, MD, MS, FRCS, FCPhleb, Charmaine C

Resecting the great saphenous stump with endothelial inversion decreases neither neovascularization nor thigh varicosity recurrence Dominik Heim, MD,

Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: Analysis of early efficacy and complications Alessandra Puggioni, MD,

High ligation combined with stripping and endovenous laser ablation of the great saphenous vein: Early results of a randomized controlled study Manfred.

Masson's tumor in the ulnar artery

Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: Short-term.

Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up

Clinical Case Nicos Labropoulos

Clinical case Symptomatic GSV varicosities with normal saphenous vein.

Femoral vein valvuloplasty: Intraoperative angioscopic evaluation and hemodynamic improvement Harold J. Welch, MD, Robert L. McLaughlin, RVT, Thomas.

Regarding “Venous ulcers and the superficial venous system”

Regarding “Ultrasound findings after radiofrequency ablation of the great saphenous vein: Descriptive analysis” Olivier Pichot, MD, Denis Creton, MD

Signs and symptoms of saphenous nerve injury after greater saphenous vein stripping: prevalence, severity, and relevance for modern practice Charles.

Presentation transcript:

SURGICAL TREATMENT OF TRUNCAL VEINS Stephen F. Daugherty, MD, FACS, RVT, RPhS

SAPHENOUS VEIN STRIPPING DESCRIBED IN BY: William Keller Charles Mayo Stephen Babcock Rose, Sidney S. Historical Development of Varicose Vein Surgery in Varicose Veins and Telangiectasias, ed. Bergan and Goldman, Quality Medical Publishing; 1993: pp

“…many believe that the operation (saphenous vein stripping) is probably obsolete.” Bergan, John J. in Rutherford’s Vascular Surgery, 6 th ed; 2005: p2258.

SURGICAL OPTIONS Open Excision Saphenous Vein Ligation Ankle-to-Groin Saphenous Stripping Segmental Saphenous Stripping All of the above often were combined with phlebectomy.

PROBLEMS WITH VEIN LIGATION FREQUENT EARLY FAILURE DUE TO COLLATERAL INCOMPETENT VEINS NEOVASCULARIZATION DUE TO GROIN DISSECTION

PROBLEMS WITH ANKLE-TO-GROIN STRIPPING SAPHENOUS NERVE INJURY STRIPPING CALF OFTEN IS UNNECESSARY INTRAOPERATIVE BLEEDING HEMATOMA CAUSING PAIN

Use slide 33 from AMP talk, showing saphenous nerve.

PROBLEMS WITH SMALL SAPHENOUS VEIN STRIPPING SURAL NERVE INJURY VARIABLE LOCATION OF TERMINATION OF SMALLL SAPHENOUS VEIN

Use slide 34 from AMP talk, sural nerve

IMPROVEMENTS IN SEGMENTAL SAPHENOUS VEIN STRIPPING STRIP KNEE-TO-GROIN ONLY ULTRASOUND IMAGING FOR PASSAGE OF STRIPPER AND HOOK RETRIEVAL OF LARGE TRIBUTARY VEINS FOR LIGATION AND DIVISION OESCH PERFORATE-INVAGINATE (PIN) STRIPPING DESCRIBED IN Goren, G., Yellin, AE, JVS 1994; 20:

WHEN TO CONSIDER OPEN SURGERY? LARGE, COMPLICATED VENOUS ANEURYSM NEAR THE SFJ HIGH LIGATION COMBINED WITH PIN STRIPPING ENDOVENOUS THERMAL ABLATION FOAM SCLEROTHERAPY VERY SUPERFICIAL LONG TRUNCAL VEIN