By Mitchel P. Goldman, Mihael Georgiev, Stefano Ricci
The single textual content particularly dedicated to the topic, this moment variation serves as an entire and sensible consultant for office-based surgical operation of varicose veins-providing a number of illustrations showcasing the anatomy of varicose veins, in addition to step by step insurance of the ambulatory phlebectomy approach.
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Additional resources for Ambulatory Phlebectomy, Second Edition (Basic and Clinical Dermatology)
Anatomical Bases of AP 17 common pattern and accounts for 26% of cases. In varicose limbs with this pattern, often only the proximal portion of the GSV is incompetent, while distally the reflux is deviated along the subcutaneous side branch(es). This is probably the most common varicose vein pattern and is one reason for limiting the GSV stripping to the proximal part of the GSV only (short or groin-to-knee stripping). Type D: In the proximal portion of the saphenous compartment, there are two veins instead of one: the GSV and the ASV.
When such GSV becomes incompetent, it may give rise to what Tibbs (16) calls “concealed” or “straight through” form of incompetence, when the diseased GSV is not visible and barely palpable because of its subfascial position. Type B: The GSV trunk is double for a certain length, with both branches lying into the saphenous compartment. This is the rare case (1%) of truly double GSV. Type C: The GSV trunk is present in all its length, but there is also a large (or even larger) subcutaneous collateral.
In particular, the last proximal incision in the site where the varicose vein enters the incompetent saphenous vein, may be used for introducing the catheter in the saphenous lumen, thereby eliminating the puncture or retrieval of the saphenous stem. Where venous diameters do not allow AP, sclerotherapy may be used. It is the case for many reticular varices or telangiectasia. At present, the introduction of a sclerosing foam has made sclerotherapy a more effective and rapid treatment xxxii Introduction to the Second Edition for varicose veins and enhance AP.
Ambulatory Phlebectomy, Second Edition (Basic and Clinical Dermatology) by Mitchel P. Goldman, Mihael Georgiev, Stefano Ricci