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Clinical Profile of Chronic Venous Insufficiency and Varicose Veins of Lower Limbs and Management in North Costal Andhra Region

Sarangam Venkata Satya , Sarangam Venkata Satya Narayana Rao1 , Palaka Srinivasa Rao2 , K. Phani Jotsna3 , U. Grace Lalitha Priya4 , Tanneru Surendra5 , Narashima Ajay6 , Aachi Srinivas7

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New Indian Journal of Surgery 10(2):p 225-233, March-April 2019. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10219.16

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Abstract

 Background: Chronic venous insufficiency of lower limbs is a common medical problem encountered by people atlarge in North-costal region of Andhra Pradesh and adjoining Odisha state. The presentation of symptoms varies from asymptomatic to cosmetic ones and if not treated in time, will lead to serious complications such as varicose ulcer and Deep vein thrombosis. Varicose veins of lower limbs is the most common peripheral vascular disease which needs proper evaluation and management. Hence the present study was undertaken to evaluate the various clinical aspects and modalities of treatment adopted for chronic venous insufficiency and varicose veins in this region. Methods: The study was conducted for a period of 2 years from February 2015 to January 2017 at GEMS and Hospital, Srikakulam, Andhra Pradesh. A total of 50 patients with Primary Varicose Veins were selected from among the admitted cases for the study. After thorough clinical examination, relevant biochemical and radiological studies were done. The patients were categorized and operated upon. The postoperative follow-up was also done. Results: In the present study, it was observed that varicose veins affect middle-aged adults (20-60 years) more commonly. Most of the patients were males (84%) and majority of them sought medical consultation for complications (22%). Long saphenous venous system involvement was seen in 60% of cases and 12% cases had both long and short saphenous venous system involvement. A good number of patients had also perforator incompetence. Saphenous-femoral flush ligation with stripping was the best surgical procedure adopted for great saphenous venous involvement and no recurrences were reported during the follow-up period. Conclusion: Surgical management was the main stay of treatment for patients with chronic venous insufficiency and varicose veins associated with complications. Flush ligation of Sapheno-femoral junction with stripping for great saphenous vein and sub-fascial ligation for perforators incompetence were found to be the best surgical procedures and yielded good results in the present study.

Keywords: chronic venous insufficiency; Duplex doppler study; sapheno-femoral junction incompetence; Trendelenburg’s surgery; varicose ulcer.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10219.16

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