Ann Surg Treat Res.  2017 Aug;93(2):98-102. 10.4174/astr.2017.93.2.98.

Early experience of transilluminated cryosurgery for varicose vein with saphenofemoral reflux: review of 84 patients (131 limbs)

• Kim KY
• Kim JW

• KMID: 2387340
• DOI: http://doi.org/10.4174/astr.2017.93.2.98

Abstract

PURPOSE
Varicose veins with great saphenous vein (GSV) insufficiency is prevalent. Among various surgical treatments for varicose veins, cryosurgery of GSV is an alternative minimally invasive technique that could leave fewer scars and replace conventional stripping with ambulatory phlebectomy. This study sought to assess outcomes including efficacy and safety of cryosurgery for varicose veins.
METHODS
One hundred thirty-one limbs in 84 patients (37 male, 47 female; mean age, 53.3 years) with varicose veins were treated with cryosurgery over a 2-year period. The patients were followed for postoperative complication with surveillance of recurrence. The analyzed variables included age, sex, symptom, operative time (from skin incision to the application of elastic bandages on the legs for compression purposes), and postoperative complications including bruising, hematoma, superficial thrombophlebitis, cellulitis, seroma, cutaneous nerve damage, and wound complication.
RESULTS
The mean operative time was 64.7 minutes for both limbs and 44 minutes for single limbs. The median number of incisions was 2. For stripping of GSV, one incision at the groin was necessary. Postoperative complications included an episode of hematoma in 3 limbs (2.3%), cutaneous nerve damage in 3 limbs (2.3%), cellulitis in 2 patients (1.5%), and seroma in 1 limb (0.8%). No wound infection, thrombophlebitis or deep venous thrombosis was observed. During follow-up (mean follow-up period, 13.5 months; range, 3-28 months), there was no recurrence.
CONCLUSION
Cryosurgery to treat varicose veins is an effective and safe treatment modality in terms of postoperative complication, cosmetic result, and recurrence.

Keyword

Varicose vein; Cryostripping; Cryosurgery; Saphenofemoral reflux

MeSH Terms

Cellulitis
Cicatrix
Compression Bandages
Cryosurgery*
Extremities
Female
Follow-Up Studies
Groin
Hematoma
Humans
Leg
Male
Operative Time
Postoperative Complications
Recurrence
Saphenous Vein
Seroma
Skin
Thrombophlebitis
Varicose Veins*
Venous Thrombosis
Wound Infection
Wounds and Injuries

Figure

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  Fig. 1 The cryomachine and cryoprobe used for the cryosurgery of varicose vein (MetrumCryoFlex; Spolka, Blizne, Poland).

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  Fig. 2 A long cryoprobe is inserted into the lumen of greater saphenous vein with care to avoid vein perforation after all the collaterals are separated, ligated and cut off to prevent recurrence.

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  Fig. 3 Picture of removed greater saphenous vein. After freezing, the cryoprobe is pulled out by a sharp jerky movement.

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  Fig. 4 The superficial varicosities is pulled out by slightly rotating the probe after freezing. Irrigationillumination device allows the operator to visualize the vein and accurate placement of additional stab incisions.

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  Fig. 5 Picture of removed superficial varicosities.

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