ArticleJournal of vascular surgery. Venous and lymphatic disorders2026
Combined treatment of deep and superficial venous reflux accelerates ulcer healing and improves symptoms: A real-world retrospective study.
Article in Journal of vascular surgery. Venous and lymphatic disorders, 2026. 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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Abstract
backgroundThe optimal surgical strategy for treating chronic venous disease with concomitant deep and superficial reflux but without iliac/proximal obstruction remains unclear. This study aimed to compare clinical symptoms, health-related quality-of-life, and ulcer outcomes between superficial venous surgery alone and combined deep-superficial surgery (performed concurrently or in stages).
methodsIn this single-center retrospective cohort, 229 patients were grouped by treatment and received superficial-only (n = 138), concurrent deep + superficial (n = 49), or staged deep + superficial (n = 42) interventions. Outcomes were Venous Clinical Severity Score (VCSS), Chronic Venous Insufficiency Questionnaire-20 (CIVIQ-20) at baseline and follow-up (1, 3, and 6 months, and last follow-up), ulcer outcomes (n = 59) assessed by healing rates and Kaplan-Meier time-to-healing analysis, duplex valve competence after deep intervention, and complications. Analyses used Welch one-way analysis of variance with Games-Howell post hoc and log-rank testing.
resultsBaseline characteristics were comparable (baseline VCSS 8.6±3.3, 9.6±4.0, and 9.0±3.9; P = .32). Between-group differences in VCSS were significant at 1 month (P = .012), 6 months (P < .001), and last follow-up (P = .017). Staged treatment reduced VCSS vs superficial-only at 1 month (mean difference [MD], -1.47; P
conclusionsIn patients with chronic venous disease with concomitant deep and superficial reflux but no iliac obstruction, adding deep reflux correction (concurrent or staged) was associated with greater and more durable symptom relief and better quality of life than superficial-only surgery, with high duplex-confirmed competence and low complication rates; ulcer healing time may be accelerated.
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