Feasibility of incompetent perforator vein excision using stab avulsion

Objectives

Whether incompetent perforator veins (IPVs) require treatment remains controversial. We retrospectively evaluated the feasibility of IPV excision performed using the stab avulsion technique without ligation and sutures in patients undergoing endovenous ablation (EA).

Methods

This was a single-center, retrospective, observational cohort study. EA was performed in 1503 consecutive patients, including 33 patients with ulcers, between December 2014 and May 2021. Varicectomy was performed using the stab avulsion technique; IPV cases were included.

Results

Stab avulsion was performed at a mean number of 11.4 ± 7.8 sites. No deep vein thromboses or pulmonary emboli were noted. The incidence of nerve injury was 0.3%. All 33 (100%) patients with ulcers achieved healing by 1 year (median: 55.5 days; range: 13–365 days).

Conclusions

IPV excision via stab avulsion may be a viable option for treating varicose veins and ulcers. This technique offers multiple advantages, including simplicity, safety, and reduced healthcare costs.

Patient literacy on varicose veins in cases presenting at university hospital of Nepal subjected for surgical management of varicose veins

Varicose veins are prominent dilated veins usually present in the lower limbs leading to complications if not managed well. Knowledge regarding varicose vein among the patients in Nepal is not yet known. We aim to examine the knowledge regarding varicose vein diagnosis and treatment among patients to better understand the barriers to care. This is a descriptive cross-sectional study adopting census sampling method. We collected data from the surgical ward where patients were admitted for surgery of varicose veins. Self-developed tool "Dhulikhel Hospital Patient Perception Questionnaire on Varicose Vein" was used for data collection after validation (Kuder-Richardson Reliability Coefficient was 0.75). Collected data were analyzed using software SPSS 23.0. Descriptive statistics was performed to present sociodemographic variables and varicose veins literacy scores. Independent sample t-test was performed for dichotomous variables and one-way ANOVA with post hoc analysis were performed for variables with multiple groups. Total 80 participants were included in the study of which 60% were men. The mean age was 45.66 years with SD 13.27. Varicose veins literacy score was high among 52.4% (more than 50% score) and low (less than 50% score) among 47.6%. There was significant mean difference (P < .01) among male and female sex, different educational groups, and different occupational groups. Patients admitted for varicose vein surgery had less than 50% knowledge in different components of varicose vein. Regular educational intervention is recommended to ensure better care of these patients.

Sinusoidal Microchannel with Descending Curves for Varicose Veins Implantation

Approximately 26% of adult people, mostly females, are affected by varicose veins in old age. It is a common reason for distress, loss of efficiency, and worsening living conditions. Several traditional treatment techniques (sclerotherapy and foam sclerotherapy of large veins, laser surgeries and radiofrequency ablation, vein ligation and stripping, ambulatory phlebectomy, and endoscopic vein surgery) have failed to handle this disease effectively. Herein, authors have presented an alternative varicose vein implant method-the descending sinusoidal microchannel (DSMC). DSMC was simulated by Fuzzy logic MATLAB (The MathWorks, Natick, MA, USA) and ANSYS (ANSYS 18.2, perpetual license purchased by Ibadat Education Trust, The University of Lahore, Pakistan) with real and actual conditions. After simulations of DSMC, fabrication and testing were performed. The silver DSMC was manufactured by utilizing a micromachining procedure. The length, width, and depth of the silver substrate were 51 mm, 25 mm, and 1.1 mm, respectively. The measurements of the DSMC channel in the silver wafer substrate were 0.9 mm in width and 0.9 mm in depth. The three descending curves of the DSMC were 7 mm, 6 mm, and 5 mm in height. For pressure, actual conditions were carefully taken as 1.0 kPa to 1.5 kPa for varicose veins. For velocity, actual conditions were carefully taken as 0.02 m/s to 0.07 m/s for these veins. These are real and standard values used in simulations and experiments. At Reynolds number 323, the flow rate and velocity were determined as 1001.0 (0.1 nL/s), 11.4 cm/s and 1015.3 (0.1 nL/s), 12.19 cm/s by MATLAB (The MathWorks, Natick, MA, USA) and ANSYS simulations, respectively. The flow rate and velocity were determined to be 995.3 (0.1 nL/s) and 12.2 cm/s, respectively, at the same Reynolds number (323) in the experiment. Moreover, the Dean number was also calculated to observe Dean vortices. All simulated and experimental results were in close agreement. Consequently, DSMC can be implanted in varicose veins as a new treatment to preserve excellent blood flow in human legs from the original place to avoid tissue damage and other problems.