[Surgical treatment of chronic venous insufficiency].
BACKGROUND
Patients with chronic venous insufficiency (CVI) may develop serious symptoms such as pain, oedema, venous claudication and leg ulcers. Conventional therapy includes compression therapy, elevation of the extremities, and in some cases surgical elimination of superficial varicose veins. This article presents and discusses surgical treatment (reconstructive deep venous surgery and transplantation) and endovascular therapy (percutaneous recanalization of post-thrombotic deep venous occlusions).


METHODS
The article is based on literature identified through non-systematic searches in the PubMed and Cochrane databases.


RESULTS
After reconstructive deep venous surgery, ulcer healing is reported in 60-78 % of cases and clinical improvement in 90 %. After such surgery, the median ulcer-free period seems to be longer in primary (congenital, familial), 54 months, than in secondary (after deep vein thrombosis) chronic venous insufficiency (18 months). Recanalization of deep venous occlusions is successful in 90 % of patients who have undergone endovascular treatment of venous claudication and leg ulcer.


CONCLUSIONS
Reconstructive deep venous surgery constitutes a real treatment choice for patients with chronic venous insufficiency for whom conventional measures have failed. The benefits are ulcer-free periods, clinical improvement, return to work and improved quality of life.
Rosales
Antonio
A
Oslo vaskulaere senter, Oslo universitetssykehus, Aker, 0514 Oslo, Norway. antonio.rosales@aus.no
Slagsvold
Carl-Erik
CE
Jørgensen
Jørgen J
JJ
Sandbaek
Gunnar
G
D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D006801:Humans; D007871:Leg Ulcer / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D014689:Venous Insufficiency / Q000601:surgery*; D014945:Wound Healing