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Introduction: Varicose veins are a common vascular problem with a high prevalence, yet they are often neglected. The main objective of this study was to explore the patient satisfaction after varicose vein surgery, along with its predicting factors. To our knowledge, no similar study has been conducted in Nepal to date., Methodology: This retrospective cross-sectional study included patients who underwent varicose vein surgery at Dhulikhel Hospital from September 2019 to February 2020. The satisfaction level after the surgery was assessed using a 10-point Likert scale questionnaire during a telephone interview with their verbal consent. Descriptive statistics and linear regression were performed to identify the predicting factors of patient satisfaction., Results: Among a total of 84 patients interviewed, 53.6% were male. The mean age of the participants was 43.13 ± 13.62 years. The mean patient satisfaction score was 42 ± 5.5, with nursing service, discharge teaching and hospital service being the highest scoring items in terms of patient satisfaction. Linear regression revealed age ≤40 years as a predictor of higher patient satisfaction (β=0.258, p=0.015) while early stage of varicose veins (β=-0.233, p=0.026) and duration of post-operative follow-up (β=-0.25, p=0.021) were negative predictors of patient satisfaction. This means that patients with C2-C3 venous disease and longer duration of postoperative follow-up tended to have lower satisfaction scores., Conclusion: The overall patient satisfaction following varicose vein surgery was very good, and the major predictors of better satisfaction were age ≤40 years, C4-C6 clinical classification of venous disease and the shorter duration of follow-up after surgery., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023. Published by Elsevier Inc.)

Varicose veins are prominent dilated veins usually present in the lower limbs leading to complications if not managed well. Knowledge regarding varicose vein among the patients in Nepal is not yet known. We aim to examine the knowledge regarding varicose vein diagnosis and treatment among patients to better understand the barriers to care. This is a descriptive cross-sectional study adopting census sampling method. We collected data from the surgical ward where patients were admitted for surgery of varicose veins. Self-developed tool "Dhulikhel Hospital Patient Perception Questionnaire on Varicose Vein" was used for data collection after validation (Kuder-Richardson Reliability Coefficient was 0.75). Collected data were analyzed using software SPSS 23.0. Descriptive statistics was performed to present sociodemographic variables and varicose veins literacy scores. Independent sample t-test was performed for dichotomous variables and one-way ANOVA with post hoc analysis were performed for variables with multiple groups. Total 80 participants were included in the study of which 60% were men. The mean age was 45.66 years with SD 13.27. Varicose veins literacy score was high among 52.4% (more than 50% score) and low (less than 50% score) among 47.6%. There was significant mean difference (P < .01) among male and female sex, different educational groups, and different occupational groups. Patients admitted for varicose vein surgery had less than 50% knowledge in different components of varicose vein. Regular educational intervention is recommended to ensure better care of these patients., (Copyright © 2021 Society for Vascular Nursing. Published by Elsevier Inc. All rights reserved.)

RM Karmacharya, BK Shrestha, B Shrestha, AK Singh, N Bhandari, P Dhakal, S Dahal Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, NepalCorrespondence: RM KarmacharyaDepartment of Surgery (Cardio Thoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel Hospital Road, PO Box no 45210, Dhulikhel, Kavrepalanchok, NepalTel +977 981 872 9013Email reachrobin773@hotmail.comIntroduction: Varicose vein is a common venous condition affecting quality of life presenting as an asymptomatic condition to a feeling of heaviness, pain, pigmentation, palpable superficial veins, itchiness and ulceration. Proper management of varicose vein is of huge importance due to its high prevalence and the impact it has on patients’ quality of life, productivity as well as on health-care resource burden. Various conservative and invasive interventions are available for the management of varicose veins. Here we present our experience with the invasive intervention of varicose veins during a period of six years at a tertiary care center (Dhulikhel Hospital) in Nepal. Although Radio Frequency Ablation (RFA) is recently introduced in Nepal, it has shown promising outcome.Method: This is a retrospective descriptive cross-sectional study between the years 2013 and 2018 at the Dhulikhel Hospital among patients that underwent surgical management of varicose veins. For ease in interpretation, patients who underwent surgery for both lower limbs in the same setting are considered as separate cases.Results: In a total of 533 limbs, the most common vein involved was isolated great saphenous vein in 70.4%. In terms of side affected, 157 patients (33.8%) were affected on the right side, 238 (51.3%) were affected on the left side and 69 (14.9%) patients had bilateral involvement. The most common clinical feature was prominent vein present in 94.5% limbs. This was followed by pain in 55.7%, pigmentation in 25.3%, itchiness in 14.6% and ulceration in 13.1%. Mean hospital stay was 1.1 days (S.D. 0.64, Range 0–3). In terms of complication, one case with deep vein thrombosis (0.18%) developed in the seventh postoperative period. There was skin burn in two cases (0.53% of RFA cases) and in 11 cases (2.06%) there was painful superficial thrombosed veins of which three required excision under local anesthesia (0.56%).Conclusion: There are multiple invasive interventions for varicose veins. With the availability of the facilities, RFA is the procedure of choice in feasible cases. The most common complication after surgical treatment was painful thrombosed superficial veins. DVT was a rare complication.Keywords: varicose veins, varicose vein surgery, radiofrequency ablation

Klippel-Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by capillary malformation, varicosities, and tissue overgrowth. It usually affects the unilateral lower extremities manifesting commonly as pain, localized rise of temperature, and venous tortuosity. However, in severe cases, ulceration, cellulitis, and chronic lymphatic malformation may be present. Management is mostly supportive and involves the use of compression stockings. Here, we report a case of KTS with a persistent lateral marginal vein of Servelle managed with radiofrequency ablation along with sclerotherapy of selected perforators. On a two-year follow-up, the symptoms had resolved and Doppler ultrasonography revealed resolution of the defective vein along with the absence of incompetent perforators. In cases with venous malformation with the persistence of embryonic avalvular venous structures, like the lateral marginal vein of Servelle, surgical intervention is warranted especially at a younger age to reduce the risk of future thromboembolic events and recurrence. Varicosities of the lateral marginal vein of Servelle can be managed successfully by radiofrequency ablation and adjunct sclerotherapy in selected cases. • Klippel-Trenaunay Syndrome (KTS) is a congenital vascular disorder which usually affects the unilateral lower extremities. • Endovenous treatment of the greater saphenous vein is gradually becoming popular in the treatment of KTS. • This case is managed by radiofrequency ablation of lateral marginal vein of Servelle. [ABSTRACT FROM AUTHOR]