Galūnių venų raidos defektų chirurginis gydymas

The diagnosis of venous malformations (VM) should be made as early in life as possible. Most of symptoms and signs of this type of vascular dysplasias are taken for manifestation of simple varicose veins or hemangiomas. Therefore surgical treatment can be inadequate and cause further deterioration of peripheral circulation in the extremities. The aim of this study was to elucidate the diagnostic possibilities to avoid mistakes in evaluating the etiology of vascularization disorders and in choosing the right method of treatment. Patients and methods The histories of the disease of 32 patients operated on for venous malformations in Vilnius University Centre of Vascular Surgery were analyzed. The methods of treatment performed by general surgeons and the treatment results obtained after establishment of the cause of vascular disturbances were assessed. The following diagnostic procedures were made: ultrasound duplex scan in 32, arteriography in 15, phlebography in 30, MRA in 6, CTA in 4 patients. Surgical treatment consisted of phlebectomy, exstirpation of the marginal vein or ligation of its branches and excision of deep extratruncular venous formations. Results Oedema had 26, ulcers 2, and pain was present in 22 patients. There were 17 patients with truncular and 15 patients with extratruncular VM. Twelve patients were operated on by general surgeons without suggesting congenital vascular malformation (CVM). These operations did not improve the peripheral circulation. Stasis decreased or disappeared in 17 (65.4%), ulcers healed in 2(100%), pain alleviation was achieved in 16 (72.7%) patients after surgery performed in the Centre. Conclusions The correct method of treatment was chosen on the background of vascular imaging. Operations resulted in palliation or vanishing of symptoms in most patients