title: Effects of surgery on microvascular function in venous insufficiency.
abstract: BACKGROUND
  The aim of our study was to assess the effects of venous stripping on microvascular functions in isolated great saphenous vein insufficiency.
  
  
  METHODS
  Two groups of participants were prospectively evaluated. The first group included 15 healthy participants without any evidence of venous insufficiency. The second group included 20 patients with varicose veins because of great saphenous vein insufficiency. The demographics, venous clinical severity scores, and CEAP classifications of the patients were recorded. Next, all individuals underwent evaluations for microvascular vasoreactivity using an iontophoretic laser Doppler imager, and the outcomes were recorded. Patients with varicose veins underwent stripping surgeries, and microvascular vasoreactivity evaluations were repeated 6 weeks postoperatively.
  
  
  RESULTS
  There was a statistically significant decrease in the patients with varicose veins compared with the control group in response to nitroprusside (SNP) applied at 4 mC in the supine position. Furthermore, there was also a significant difference in the response to acetylcholine (ACh) in patient group in the sitting position (P < 0.05). We also observed a statistically significant decrease in the responses to SNP applied for 1, 2, and 4 mC (P < 0.05) in the patients in the sitting position. The relief of pain and edema after surgery was found to be significant (P < 0,001). In the subgroup in which ACh was applied for 1 and 4 mC in the supine position, postoperative microvascular flow was significantly increased (P < 0.005). Moreover, based on the measurements taken in the supine position, the patients in the subgroup in which SNP was applied for 1, 2, or 4 mC exhibited significantly increased postoperative microvascular dilatation (P < 0.005).
  
  
  CONCLUSIONS
  Saphenous vein insufficiency impairs the endothelium-dependent vasodilatation response in the perimalleolar region, and partial recoveries in microvascular function were observed after surgical treatment.
authors.affiliation: Ankara Penal Institution Campus State Hospital, Department of General Surgery, Ankara, Turkey. Electronic address: yusufsevim@gmail.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Sevim
authors.affiliation: Ankara University Medical School, Department of General Surgery, Ankara, Turkey.
authors.forename: Zahide
authors.initials: Z
authors.lastname: Unal
authors.affiliation: Ankara University Medical School, Department of General Surgery, Ankara, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Koksoy
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency; D014656:Vascular Surgical Procedures; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*