ArticleObstetric medicine2014
The effect of pregnancy on venous valve repair to the sapheno-femoral junction for varicose veins.
Article in Obstetric medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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0 citing papers in PubMed, 6 citations in OpenAlex.
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesPregnancy represents a special situation where both the mechanical and hormonal instigating factors of varicose veins are reversible with the venous valve cusps preserved. Exostent venous valve repairs are a physiological alternative which minimises stimulus to collateral growth (recurrence). The study purpose was to assess the effect of pregnancy on the durability of valve repairs.
methodsIn a prospective study of 36 limbs, 20 young females (30 ± 4.7 years) had an exostent implanted to the terminal valve of the saphenofemoral junction for varicose veins. At routine long-term follow up (9.7 ± 3.8 years), 38 pregnancies were completed (mean: 1.8, range: 1-4). The controls were a non-pregnant group of limbs (n = 386).
resultsAt 9.7 years, the internal diameter of the greater saphenous vein (GSV) changed from 7.8 ± 2.8 mm preoperatively to 4.5 ± 1.4 mm post-operatively. Recurrence was associated with reflux, preoperative deep system and ovarian vein involvement. Pregnancy induced 33.3% recurrences compared with non-pregnant controls (4.7%) similarly treated or 22.8% compared with non-pregnant ablative controls. At 9.7 years, symptomatic improvement continued with significantly better CEAP status (described later) (31CSEAP preoperative to 6CSEAP) with no further truncal ablation (strip, laser) required.
conclusionsVenous valve repairs can withstand the special stresses of pregnancy. There is no need to ablate the GSV. This approach is contrary to the traditional dictum; the treatment of varicose veins should be delayed until the family is completed.
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