Light reflection rheography and clinical course of patients with advanced venous disease before and after endoscopic subfascial division of perforating veins.
BACKGROUND
Endoscopic subfascial division of perforating veins (ESDP) has been shown to cause fewer surgical complications than classic techniques.


OBJECTIVE
To evaluate the efficacy of ESDP based on patients' symptoms, rheographic data, and ulcer healing.


METHODS
Thirty-two subsequent patients underwent 40 ESDP procedures. Fifteen limbs presented with a postthrombotic syndrome (PTS), and 16 cases had an active venous ulcer. Data were recorded before and 2 months after ESDP. Stripping or high ligation procedures had been previously performed.


RESULTS
The symptoms of pain and edema improved in 80% (PTS) and 74% (venous ulcer) of patients. Only one case did not show improvement of either pain or edema. Fifty-eight percent of patients showed hemodynamic improvement by light reflection rheography (LRR), while 32% did not change and 10% of patients had a worsened LRR after ESDP. The LRR refilling times increased by a median factor of 1.69, reaching at least 20 seconds in nine of 40 limbs. Venous ulcers that had been active for a median of 12 years (range, 0.5-21) healed in nine of 16 cases within 14-50 days (median, 21 days).


CONCLUSIONS
ESDP reduces disease-related symptoms, improves hemodynamics in almost 60%, and facilitates healing of long lasting venous ulcers.
Department of Dermatology, University of Ulm, Germany.
T M
TM
Proebstle
G
G
Weisel
U
U
Paepcke
S
S
Gass
L
L
Weber
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004487:Edema / Q000601:surgery; D004724:Endoscopy; D005069:Evaluation Studies as Topic; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D017156:Photoplethysmography; D011186:Postphlebitic Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow / Q000502:physiology; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex; D014647:Varicose Ulcer / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014680:Veins / Q000601:surgery; D014945:Wound Healing