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Nerve Injury due to Endovenous Thermal Ablation for Varicose Veins

  • Shoaib F. Padaria
Chapter

Abstract

Superficial venous insufficiency of the lower limbs is a common condition, involving up to 35% of women and 15% of men [1]. Ligation and stripping of the great saphenous vein (GSV) and small saphenous vein (SSV) at their junctions has been the standard of care for many decades. Surgery performed under general, spinal, epidural or, occasionally, regional anaesthesia was associated with a high recurrence rate of up to 40% at 5 years [2]. Nerve damage with patient complaints of post-operative pain was commonly reported in between 7 and 40% but was of clinical relevance in a smaller number of patients [3].

References

  1. 1.
    Callam MJ. Epidemiology of veins. Br J Surg. 1994;81:167–73.CrossRefGoogle Scholar
  2. 2.
    Darke SG. Morphology of recurrent varicose vein. Eur J Vasc Surg. 1992;6:512–7.CrossRefGoogle Scholar
  3. 3.
    Morrison C, Dalsing MC. Signs and symptoms of saphenous nerve injury after GSV stripping, prevalence, severity and relevance to modern practice. J Vasc Surg. 2003;38:886–90.CrossRefGoogle Scholar
  4. 4.
    Navarro L, Min RJ, Boné C. Endovenous laser a new minimally invasive method of treatment for varicose veins- preliminary observations using 810 nm diode laser. Dermatol Surg. 2001;27:117–22.PubMedGoogle Scholar
  5. 5.
    Goldman MP, Amiry S. Closure of the greater saphenous vein with endoluminal radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: 50 patients with more than 6-month follow-up. Dermatol Surg. 2002;28:29–31.PubMedGoogle Scholar
  6. 6.
    Belcaro G, Nicolaides AN, Ricci A, et al. Endovascular sclerotherapy, surgery and surgery plus sclerotherapy in superficial venous incompetence: a randomized, 10 year follow up trial- final results. Angiology. 2000;51:529–34.CrossRefGoogle Scholar
  7. 7.
    Campbell WB, France F, Goodwin HM. Medicolegal claims in vascular surgery. Ann R Coll Surg Engl. 2002;84:181–4.CrossRefGoogle Scholar
  8. 8.
    Sam RC, et al. Eur J Vasc Endovasc Surg. 2004;27:113–20.CrossRefGoogle Scholar
  9. 9.
    Murakami G, Negishi N, et al. Okajimas Folia Anat Jpn. 1994;71(1):21–33.CrossRefGoogle Scholar
  10. 10.
    Lees TA, Beard JD, Ridler BMF, Szymanska T. A survey of the current management of varicose veins by members of the Vascular Surgical Society. Ann R Coll Surg Engl. 1999;81:407–17.PubMedPubMedCentralGoogle Scholar
  11. 11.
    MacKenzie RK, Paisley A, Allan PL, Lee AJ, Ruckley CV, Bradbury AW. The effect of long saphenous vein stripping on quality of life. J Vasc Surg. 2002;35:1197–203.CrossRefGoogle Scholar
  12. 12.
    Stuart WP, Adam DJ, Allan PL, Ruckley CV, Bradbury AW. Saphenous surgery does not correct perforator incompetence in the presence of deep venous reflux. J Vasc Surg. 1998;28:834–8.CrossRefGoogle Scholar
  13. 13.
    Weiss RA, Weiss MA. Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: a 2-year follow-up. Dermatol Surg. 2002;28(1):38–42.PubMedGoogle Scholar
  14. 14.
    Merchant RF, dePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: a multicentre study. J Vasc Surg. 2002;35:1190–6.CrossRefGoogle Scholar
  15. 15.
    Fassiadis N, Kianifard B, Holdstock JM, Whiteley MS. A novel approach to the treatment of recurrent varicose veins. Int Angiol. 2002;21:275–6.PubMedGoogle Scholar
  16. 16.
    Beale RJ, Mavor AID, Gough MJ. Heat dissipation during endovenous laser treatment of varicose veins: is there a risk of nerve injury? Phlebology. 2006;21:32–51.CrossRefGoogle Scholar
  17. 17.
    Proebstle TM, Lehr HA, Kargl A, Espinola-Klein C, Rother W, Bethge S, et al. Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg. 2002;35:729–36.CrossRefGoogle Scholar
  18. 18.
    Min RJ, Zimmet SE, Isaacs MN, Forrestal MD. Endovenous laser treatment of the incompetent greater saphenous vein. J Vasc Interv Radiol. 2001;12:1167–71.CrossRefGoogle Scholar
  19. 19.
    Englehorn CA, Englehorn AL, Cassou MF, Salles-Cunha SX. Patterns of saphenous reflux in women with varicose veins. J Vasc Surg. 2005;41:645–51.CrossRefGoogle Scholar
  20. 20.
    Gibson KD, et al. Endovenous laser treatment of the short saphenous vein: efficacy and complications. J Vasc Surg. 2007;45(4):795.CrossRefGoogle Scholar
  21. 21.
    Proebstle TM, Gul D, Karg l A, Knop J. Endovenous laser treatment of the lesser saphenous vein with a 940 nm diode laser: early results. Dermatol Surg. 2003;29:357–61.PubMedGoogle Scholar
  22. 22.
    Lucerni G, et al. Injury to the CPN during surgery of the SSV. Phlebology. 1999;14:26–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Shoaib F. Padaria
    • 1
  1. 1.Department of Vascular SciencesJaslok Hospital and Research CentreMumbaiIndia

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