The Vein Stripping Ablation and Phlebectomy



Fig. 21.1
Normal superficial venous anatomy



Vein surgery is appropriate for patients manifesting classic venous symptoms of aching leg pain with edema, visible varicose veins, and duplex ultrasound proven superficial venous incompetence.



Preoperative Preparation


A presurgical trial of elastic compression with symptom improvement is predictive of successful surgical results. All patients should have duplex sonographic proof of reflux greater than 0.5 s and saphenous vein diameter >5 mm. Immediately prior to surgery mapping the varicosities with the patient standing facilitates phlebectomy.


Operative Strategy


There are two components to surgery, which may be staged, by surgeons preference

1.

Elimination of reflux: endovenous ablation vs. open stripping

 

2.

Phlebectomy of varicosities

 


Operative Technique (Fig. 21.2)




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Fig. 21.2
Endovenous catheter mode of action



1.

Endovenous ablation using radiofrequency vs. laser energy. Although the hardware required differs somewhat the procedure is similar and entails:

Apr 6, 2017 | Posted by in CRITICAL CARE | Comments Off on The Vein Stripping Ablation and Phlebectomy

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