Camilli Daniele, Platone Alessandro, Ruggeri Massimo, Furgiuele Sergio
Department of Vascular Surgery, San Camillo de Lellis Hospital, Rieti, Lazio, Italy.
Department of Vascular Surgery, Isitituto Dermatologio dell'Immacolata (IDI IRCCS), Roma, Lazio, Italy.
Int J Angiol. 2020 Dec;29(4):245-249. doi: 10.1055/s-0040-1715132. Epub 2020 Sep 20.
Evaluation of the outcomes of OSES (oval-shaped external support), a novel device for external valvuloplasty of the great saphenous vein (GSV) for the conservative treatment of superficial venous insufficiency. Between 2012 and 2015, 30 patients underwent external valvuloplasty of the GSV for a total of 32 limbs. Patients were subjected to clinical and instrumental follow-up by a half-year ultrasound for a minimum of 36 months. The main endpoints were the recurrence of varicose disease, persistent or recurrent venous reflux, and venous thrombosis. Varicose recurrence was verified in six limbs on 32 (18.75%). Four limbs (12.5%) presented a recurrence of the reflux even in the absence of varicose veins. Two limbs (6.25%) underwent saphenectomy after the valvuloplasty intervention at 12 and 18 months, respectively, because of the presence of saphenofemoral reflux and varicose recurrences. No case of venous thrombosis of the saphenous trunk was observed. The external valvuloplasty of the GSV is a well-known technique that used to treat the superficial venous insufficiency. The newly introduced OSES device seems to show better midterm results, due to a better alignment of the valve flaps. In our experience, the use of this device gives better long-term results and allowed to extend the indication to patients with saphenic diameters that were considered not eligible for repair. In conclusion, although our data needs further confirmation, OSES device might represents a new interesting opportunity for reconstructive venous surgery.
评估一种用于大隐静脉(GSV)体外瓣膜成形术以保守治疗浅静脉功能不全的新型装置——椭圆形外部支撑装置(OSES)的效果。2012年至2015年期间,30例患者共32条肢体接受了大隐静脉体外瓣膜成形术。患者接受临床和仪器随访,每半年进行一次超声检查,至少随访36个月。主要终点是静脉曲张疾病复发、持续性或复发性静脉反流以及静脉血栓形成。32条肢体中有6条(18.75%)出现静脉曲张复发。即使在没有静脉曲张的情况下,仍有4条肢体(12.5%)出现反流复发。由于存在大隐股静脉反流和静脉曲张复发,分别在瓣膜成形术干预后的12个月和18个月,有2条肢体(6.25%)接受了大隐静脉切除术。未观察到隐静脉主干静脉血栓形成的病例。大隐静脉体外瓣膜成形术是一种用于治疗浅静脉功能不全的知名技术。新引入的OSES装置似乎显示出更好的中期效果,这是由于瓣膜瓣叶的排列更好。根据我们的经验,使用该装置可获得更好的长期效果,并允许将适应症扩大到那些被认为不符合修复条件的大隐静脉直径的患者。总之,尽管我们的数据需要进一步证实,但OSES装置可能代表了重建静脉手术的一个新的有趣机会。