Liebetrau D, Marnoto R, Goßlau Y, Zerwes S, Stangl Franz, Wohlgemuth W A, Hyhlik-Dürr A
Gefäßchirurgie, Medizinische Fakultät, Universität Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.
Klinik für Gefäßchirurgie und endovaskuläre Chirurgie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.
Chirurgie (Heidelb). 2022 Sep;93(9):892-898. doi: 10.1007/s00104-022-01648-1. Epub 2022 Jun 29.
The marginal vein (MV) is a congenital, predominantly venous vascular malformation, which is based on a lack of regression of the embryonic venous system in the lower extremities and is associated with a variety of complications. So far, no uniform treatment regimens have been described in the literature.
What are the treatment strategies and outcomes in patients with a MV?
In the period from 1 January 2008 to 31 December 2020, all patients treated at the University Hospital Augsburg with MV were retrospectively reviewed.
The median age at the time of diagnosis was 14.8 years (3-42 years). Out of 16 patients 12 had a leg length difference, 75% of patients (12/16) already had chronic venous insufficiency (CVI) at the time of diagnosis of MV. Open surgical removal of MV was performed as first-line treatment in 31.3% (5/16) patients. The MV was primarily closed by endovenous laser therapy (EVLT) in 1/16 patients, 15/16 patients were treated with redo procedures and 2.6 ± 2.4 (mean±SD) redo procedures were performed per patient in follow-up. The mean follow-up was 8.1 years.
In order to prevent/avoid progression of CVI and thrombosis prophylaxis, the MV should be closed/removed promptly after diagnosis. The use of conventional surgical techniques for the removal of MV seems to have an advantage over treatment with minimally invasive procedures in terms of the number of secondary interventions required.
边缘静脉(MV)是一种先天性的、主要为静脉性的血管畸形,其基础是下肢胚胎静脉系统缺乏退化,并伴有多种并发症。迄今为止,文献中尚未描述统一的治疗方案。
MV患者的治疗策略和结果是什么?
回顾性分析2008年1月1日至2020年12月31日在奥格斯堡大学医院接受治疗的所有MV患者。
诊断时的中位年龄为14.8岁(3 - 42岁)。16例患者中,12例存在腿长差异,75%的患者(12/16)在MV诊断时已患有慢性静脉功能不全(CVI)。31.3%(5/16)的患者将开放性手术切除MV作为一线治疗。1/16的患者主要通过静脉内激光治疗(EVLT)封闭MV,15/16的患者接受了再次手术,随访期间每位患者平均进行2.6±2.4(均值±标准差)次再次手术。平均随访时间为8.1年。
为了预防/避免CVI进展和血栓形成,MV应在诊断后立即封闭/切除。就所需的二次干预次数而言,使用传统手术技术切除MV似乎比微创手术治疗更具优势。