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第28回日本静脈学会総会シンポジウム2(2008年学会資料)

Theme 2

Proposed Guideline for EVLT

【Pathological mechanism of recurrences】

20 patients were referred to our hospital for recurrent varix after their stripping surgery (mean time from first surgery: 10.2 years)

【Analysis of Risk factors for recurrence】

・Incompetent perforator vein in our patients

・Varicose vein diameter on CEAP classification

【Outcomes of EVLT in the previous literature】

・Results of EVLT for varicose veins in lower limbs

We applied EVLT with High ligation especially for the varix with higher CEAP grading.

Our results were comparable to the best ones in the past literature.

【Discussion】
  • ・Residual taributaries, incompetent perforator, and neovascularization are important factors as  cause of recurrence.
  • ・EVLT can achieve the excellent results even for the CEAP 4-6 saphenous varicose vein in combination with high ligation.
  • ・EVLT with high ligation is very effective for varicose with reflux from tributaries and incompetent perforators.
【Proposal of Guideline for EVLT】

Key Surgical Techniques to prevent neovasculogenesis after EVLT

  • ・Perform proper high ligation.
  • ・Leave epigastric vein in case of many tributaries.
  • ・Create the efficient anatomical barrier with closure of the cribriform fascia.
  • ・Avoid high ligation for less severe varicose veins.