Darke S G
Department of Vascular Surgery, Royal Bournemouth Hospital, U.K.
Eur J Vasc Surg. 1992 Sep;6(5):512-7. doi: 10.1016/s0950-821x(05)80626-7.
Over an 18-month period, of 444 patients referred for treatment for varicose veins, 95 (21%) had had previous surgery. By means of clinical hand-held Doppler and in selected venographic evaluation these were subdivided into three groups as follows. Type 1:29 of the 95 patients had recurrence through thigh perforators. Type 2:10 patients had developed incompetence through a second saphenous system, in nine of the 10 in the short saphenous having had previous long saphenous surgery. Type 3:46 patients had recurrent sapheno-femoral incompetence and 10 sapheno-popliteal incompetence. A persistent long saphenous trunk in the thigh was present in approximately two-thirds of cases of types 1 and 3. In over half of the type 3 patients saphenofemoral recurrence was by reconstitution of the junction by neovascularisation. These morphological studies demonstrate why there may be an increased risk of recurrence if the long saphenous trunk is not excised at the time of primary surgery.
在18个月的时间里，444名因静脉曲张转诊接受治疗的患者中，95名（21%）曾接受过手术。通过临床手持多普勒检查和部分静脉造影评估，这些患者被分为以下三组。1型：95名患者中有29名通过大腿穿通静脉复发。2型：10名患者通过第二个隐静脉系统出现功能不全，10名患者中有9名在小隐静脉出现功能不全，此前接受过大隐静脉手术。3型：46名患者出现股隐静脉功能不全复发，10名患者出现腘隐静脉功能不全。在1型和3型病例中，约三分之二的患者大腿部存在持续的大隐静脉主干。超过一半的3型患者股隐静脉复发是通过新生血管重建交界处。这些形态学研究表明了为什么在初次手术时不切除大隐静脉主干可能会增加复发风险。
