Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Early Results of Cryosurgery in Varicose Veins in Korea: Safety and Feasibility

  • Yi, Eun-Jue (Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Lee, Sung-Ho (Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Cho, Jong-Ho (Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Kim, Kwang-Taik (Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine)
  • Received : 2011.09.09
  • Accepted : 2011.11.25
  • Published : 2012.06.05
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Abstract

Background: Cryosurgery was recently introduced as a treatment for varicose veins in the lower extremities. Cryosurgery with freezing probes can be used to remove the great saphenous vein (GSV) via an inguinal incision alone. The aim of this study was to assess early outcomes and the feasibility of cryosurgery for varicose veins. Materials and Methods: Forty patients were enrolled in the present study from March 2009 to July 2010. All patients underwent careful physical examinations, and their GSV reflux was demonstrated by duplex ultrasonography. Clinical severity was measured according to the clinical-etiology-anatomy-pathophysiology (CEAP) classification. The impaired GSVs were removed with rigid cryoprobes after freezing. Patients had follow-up appointments at 1 week, 1 month, 3 months, and 6 months after surgery. Sclerotherapy was performed during follow-up on an outpatient basis as needed. Results: A total of 19 men and 21 women were enrolled. The mean follow-up duration was 3.4 months (range, 1 to 12 months). The clinical severity ranged from CEAP 2 to CEAP 6a. Thirty-eight patients underwent concomitant phlebectomy during surgery. No recurrences were reported during follow-up. There were three cases of minor complications. Two patients had paresthesia, and one had thrombophlebitis. Conclusion: Using cryosurgery techniques to treat varicose veins, the complication rates were minimal and outcomes were comparable to those of previous reports. This procedure is a safe and feasible treatment modality for varicose veins.

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References

  1. Schouten R, Mollen RM, Kuijpers HC. A comparison between cryosurgery and conventional stripping in varicose vein surgery: perioperative features and complications. Ann Vasc Surg 2006;20:306-11. https://doi.org/10.1007/s10016-006-9051-x
  2. Callam MJ. Epidemiology of varicose veins. Br J Surg 1994;81:167-73. https://doi.org/10.1002/bjs.1800810204
  3. Beale RJ, Gough MJ. Treatment options for primary varicose veins: a review. Eur J Vasc Endovasc Surg 2005;30: 83-95. https://doi.org/10.1016/j.ejvs.2005.02.023
  4. Kouri B. Current evaluation and treatment of lower extremity varicose veins. Am J Med 2009;122:513-5. https://doi.org/10.1016/j.amjmed.2009.01.019
  5. Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol 2003;14:991-6. https://doi.org/10.1097/01.RVI.0000082864.05622.E4
  6. van den Bos RR, Kockaert MA, Neumann HA, Nijsten T. Technical review of endovenous laser therapy for varicose veins. Eur J Vasc Endovasc Surg 2008;35:88-95. https://doi.org/10.1016/j.ejvs.2007.08.005
  7. Harris EJ Jr. Endovascular obliteration of saphenous vein reflux: a perspective. J Vasc Surg 2002;35:1292-4. https://doi.org/10.1067/mva.2002.124624
  8. Sybrandy JE, Wittens CH. Initial experiences in endovenous treatment of saphenous vein reflux. J Vasc Surg 2002;36: 1207-12. https://doi.org/10.1067/mva.2002.128936
  9. Le Pivert P. Controlled cryosurgery of varices of the lower extremities: a new therapeutic approach. Apropos of 350 cases. Phlebologie 1987;40:123-48.
  10. Breuninger H. Cryostripping of the long saphenous vein with a percutaneously guided probe. Dermatol Surg 2001;27: 545-8. https://doi.org/10.1046/j.1524-4725.2001.00194.x
  11. Schouten R, Mollen RM, Kuijpers HC. A comparison between cryosurgery and conventional stripping in varicose vein surgery: perioperative features and complications. Ann Vasc Surg 2006;20:306-11. https://doi.org/10.1007/s10016-006-9051-x
  12. Disselhoff BC, Buskens E, Kelder JC, der Kinderen DJ, Moll FL. Randomised comparison of costs and cost-effectiveness of cryostripping and endovenous laser ablation for varicose veins: 2-year results. Eur J Vasc Endovasc Surg 2009; 37:357-63. https://doi.org/10.1016/j.ejvs.2008.11.013
  13. Klem TM, Wittens CH. Cryoperforator surgery: a new treatment of incompetent perforating veins. Vasc Endovascular Surg 2008;42:239-42. https://doi.org/10.1177/1538574407312655
  14. Shim YK, Soh DM. Cryosurgical treatment of varicose vein in 1,157 cases. J Korean Soc Phlebol 2011;10:1-10.
  15. Leopardi D, Hoggan BL, Fitridge RA, Woodruff PW, Maddern GJ. Systematic review of treatments for varicose veins. Ann Vasc Surg 2009;23:264-76. https://doi.org/10.1016/j.avsg.2008.10.007

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