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Mechanical Inhibition of Angiogenesis at the Saphenofemoral Junction in the Surgical Treatment of Varicose Veins
- Source :
- Circulation. 118:66-74
- Publication Year :
- 2008
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2008.
-
Abstract
- Background— Saphenofemoral junction (SFJ) ligation has been a major component of surgical intervention for varicose veins; however, recurrence occurs in as many as 40%. Neovascularization with reconnection of the venous channels at the transected SFJ has been identified as the major cause of this recurrence. This randomized controlled study sought to evaluate mechanical suppression of neovascularization at the SFJ, with the use of a synthetic patch, to prevent recurrence after ligation surgery. Methods and Results— A total of 389 limbs (from 292 patients) were randomized into either control (SFJ ligation surgery) or patch (SFJ ligation with polytetrafluoroethylene patch of the transected SFJ) groups. All patients underwent clinical assessment, duplex imaging, and air plethysmography studies preoperatively and at 1, 6, 12, and 36 months postoperatively. The patch consistently halved the recurrence rate to 3 years postoperatively in all clinical subgroups. In those patched SFJs that still developed recurrence, evidence of neovascularization circumventing the polytetrafluoroethylene patch was observed by both ultrasound and histology. Conclusions— This study demonstrates that use of a polytetrafluoroethylene patch is an effective mechanical suppressant of neovasculogenesis at the SFJ and can be safely used as a strategy to improve long-term outcome of varicose vein surgery.
- Subjects :
- Male
medicine.medical_specialty
Time
law.invention
Varicose Veins
Neovascularization
Double-Blind Method
Randomized controlled trial
law
Physiology (medical)
Varicose veins
Secondary Prevention
Humans
Medicine
Plethysmograph
Saphenous Vein
Ligation
Polytetrafluoroethylene
Leg
Varix
Equipment Safety
Neovascularization, Pathologic
business.industry
Vascular disease
Prostheses and Implants
Middle Aged
medicine.disease
Surgery
Treatment Outcome
Venous Insufficiency
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Varices
Vascular Surgical Procedures
Follow-Up Studies
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 118
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....6412f027d15a3d5abf7043bda0ee5cfb