Constantin J M, Etienne G, Hévia M
Unité de Chirurgie Vasculaire, Clinique Saint-Joseph, Angoulême.
Ann Chir. 1997;51(7):745-8.
Stripping of varicose veins, a reference method, causes postoperative pain and sometimes dysesthesia due to saphenous nerve damage. Ankle wound healing is sometimes painful and often unaesthetic. Invaginated stripping eliminates some of the drawbacks, but keeps the lower wound and must be left in the case of recurrent saphenous rupture. Those two techniques do not allow total saphenous resection in the case of infected ulcers. Cryosurgery can be used regardless of the state of the ankle skin. It allows a complete invaginated stripping without ankle wound.
Over a 9-year period, 6157 limbs (3255 patients) underwent cryosurgery for varicose veins. The indication in 88% of cases was based on functional or aesthetic reasons and in 7% of the cases, hypodermitis, in 3% ulcerations and in 2% superficial venous thrombosis.
Postoperatively, a single case of sural phlebitis was observed. Frequency and intensity of pain and hematomas are decreased. Thanks to this technique, the lower incision can be avoided thus giving better aesthetic results.
Cryosurgery for varicose veins can be used in any circumstances. It has a similar efficacy to the stripping technique. Aesthetic and functional results are better. It is an important improvement especially in case of ulceration.
