Endoscopic Treatment of Chronic Venous Insufficiency by Interrupting Below Knee Perforating Veins: A Prospective Study
Journal Title: Journal of Medical Science And clinical Research - Year 2016, Vol 4, Issue 1
Abstract
Chronic venous insufficiency (CVI) is a long-term disabling problem. The prevalence of venous ulceration due to chronic venous insufficiency has been estimated to be approximately 0.1 to 0.3%.1 In addition for each patient with frank ulceration, there are up to 30 patients with lipodermatosclerosis.2 Perforating veins which connect deep and superficial venous systems are thought to play an important role in the pathogenesis of these ulcers .The management of ulceration associated with chronic venous insufficiency remains difficult and associated with high failure rates. Cutaneous venous hypertension which occurs as a consequence of primary valvular incompetence is up to 60% of patients3 . Although superficial stripping, deep venous valve repair and valve transfer all have their advocates, the mainstay of therapy has remained mechanical compression. External elastic stockings, worn by compliant patients, contributes to ulcer healing in 85% of cases.4-5 However compliance is difficult to obtain in the elderly and infirm, due to difficulty in applying the stockings as well as poor compliance in hot climates. Most importantly, ulcer recurrence remains an unsolved problem. Even in the best series using non-operative management, ulcer recurrence at a mean followup of 30 months was 33% and all ulcers recurred in non-compliant patients.5
Authors and Affiliations
Dr Jitendra Kumar Kushwaha
Keywords
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