[Significance of ligature of early detected insufficient perforated lower extremities veins as a cause of the varicose syndrome].

BACKGROUND/AIM: Perforated veins (PV) connect surface and deep veins net. Insufficient perforated veins (IPV) are considered to be one of the causes of the venous stasis syndrome. Ligating IPV removes increased pressure transmission from the deep veins to the surface veins system and prevents the occurrence of varicosis, as well. The aim of the study was to determine surface veins diameters prior and after the surgical operation on IPV, and to confirm good results of the treatment with this method in removing causes of the surface veins varicosis.

METHODS

The study included 30 patients of both sexes (25 males and 5 females), mean age 30.10 +/- 10.24 years. The patients were classified in accordance with CEAP (clinical severity, ethiology or cause, anatomy, pathophysiology) classification as those with the initial varicous syndrome based on IPV. Any of the patients were submitted to color Doppler echophlebography. In case of diameter > or = 3.5 mm PV were marked as IPV. All of the IPV were divided into two groups, the group I being with ostium in the stem of Vena Saphena Magna (VSM) or Vena Saphena Parva (VSP), while the group II was with ostium in the venous tributors. VSM and VSP diameters at the level of IPV ostium, bellow and above (1 cm) the ostium were measured prior to IPV ligature, and 30 days after the surgical intervention.

RESULTS

Comparing the results the highest ligature effects were shown at the level of IPV ostium in the stem of VSM and VSP of both groups (p < 0.0001) with the highest diameter reduction. There was a smaller reduction of diameter in the proximal and distal segment of ostium in the group I, while there was no diameter change in the distal segment of ostium in the group II.

CONCLUSION

Saphenous stem diameter reduction at the level of ostium, proximally and distally of the confluence, confirms the significance of IPV ligature before pronounced varicosis appears.