Pre-operative evaluation and treatment of patients with chronic venous insufficiency.

OBJECTIVE

To describe the use of radionuclide venography (RV) in the detection of the site(s) of blood reflux through incompetent perforating veins (IPVs) of the leg of patients with chronic venous insufficiency (CVI).

EXPERIMENTAL

DESIGN

Prospective study in which we evaluated our experience in the assessment and treatment of patients with moderate or severe CVI with a follow-up ranging between 6 and 48 months.

SETTING

A surgical service of the Department of Surgery of the University of Rome "Tor Vergata".

PATIENTS: Fifty-three patients with CVI that were referred to our service to be surgically treated.

INTERVENTIONS: Physical examination, RV, and surgical procedures of ligation of IPVs.

MEASURES: Based on pre- and post-operative physical examination and RV.

RESULTS

The patency of deep venous system and the presence of 1 to 3 leg IPVs was confirmed preoperatively in all the limbs either with physical examination and RV. After surgery, non-ulcerated skin changes improved and all the ulcers healed within 45 days. Postoperative RV showed that the IPVs had disappeared from the affected areas in 56 limbs. Two ulcers recurred after two and six months respectively.

CONCLUSIONS

RV showed to be a reliable method to exactly detect IPVs. This method is useful to guide the ligation of IPVs in patients with moderate or severe CVI.