الفهرس | Only 14 pages are availabe for public view |
Abstract Conventional varicose vein surgery has been the standard of care for primary varicose veins because of the high failure rates of liquid sclerotherapy which became apparent in the 1970s. Long term trials, however, have uncovered the high recurrence rate after varicose vein surgery. The use of air and a sclerosing drug in combination is not new. It was described in 1944 by Orbach: the airblock technique. It has continuously been improved in the past decades. The sclerosing solution was added to air, by simply shaking the syringe or the vial to produce large bubbles which had a high air/liquid ratio and with increased efficacy only for smaller veins, this method was not suitable for larger veins. The use of current methods (e.g. Tessari method) in sclerosing foam in the treatment of varicose veins is becoming an established therapy with a high immediate success rate, low cost, and low complication rate. Th e high incidence of recurrence is largely the result of recanalisation of the GSV following sclerotherapy. Therefore,is connection of the incompetent saphenofemoral junction with surgical stripping is the gold standard treatment for great saphenous varicose veins against which the results of all new methods of varicose veins must be judged. As in all other branches in surgery, less invasive procedure and a move to cheaper day case or outpatient intervention have resulted in re-assessment of current therapies. Conventional varicose vein surgery has been the standard of care for primary varicose veins because of the high failure rates of liquid sclerotherapy which became apparent in the 1970s. Long term trials, however, have uncovered the high recurrence rate after varicose vein surgery. The use of air and a sclerosing drug in combination is not new. It was described in 1944 by Orbach: the airblock technique. It has continuously been improved in the past decades. The sclerosing solution was added to air, by simply shaking the syringe or the vial to produce large bubbles which had a high air/liquid ratio and with increased efficacy only for smaller veins, this method was not suitable for larger veins. The use of current methods (e.g. Tessari method) in sclerosing foam in the treatment of varicose veins is becoming an established therapy with a high immediate success rate, low cost, and low complication rate.T h e high incidence of recurrence is largely the result of recanalisation of the GSV following sclerotherapy. Thereforebr study we combined high ligation with foam sclerotherapy, a treatment that theoretically would have a lower recurrence rate than foam sclerotherapy along). |