脈管学55巻7号　pp

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1 Online publication August 10, 原著 55 要旨 : EHIT class 1 class 2, 3 1 J Jpn Coll Angiol 2015; 55: Key words: saphenous vein surgery, saphenous vein stump, endovenous heat-induced thrombosis (EHIT), varicose vein, deep vein thrombosis 序言 1, 2 3, 4 対象と方法 Endovenous Heat-Induced Thrombosis EHIT 5, 6 EHIT class 1 class doi: /jca InvisiGrip TM vein stripper Le Maitre Vascular t p< THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 55

2 106 結果 Table ± CEAP C2 8 C3 13 C4a 7 C class 3 Table 2 Fig EHIT Class EHIT class class EHIT class class 2 class class 1 6 class 1 6 class class 2 16 class 1 AT3 Table 1 Patients background Age 62.1±11.5 Sex male 4 (6 limbs, 6 veins) female 14 (23 limbs, 25 veins) Vein GSV 23 SSV 8 Side rt 14 lt 15 Anesthesia spinal 14 local 4 CEAP C2 8 classification C3 13 C4a 7 C5 1 GSV, great saphenous vein; SSV, small saphenous vein Table 2 Classification of thrombus Thrombus classification 6 days after operation 4 weeks after operation 16 weeks after operation Overall none EHIT class class class class GSV none EHIT class class class class SSV none EHIT class class class class GSV, great saphenous vein; SSV, small saphenous vein β2gp1 C S CT 6 class class 1 脈管学 Vol. 55

3 107 Figure 1 Classification of thrombus. A: Saphenous stump without thrombus. B: Class 1: Saphenous stump with thrombus not extending into deep vein. C: Class 2: Saphenous stump thrombosis with extension into deep vein of a cross-sectional area of less than 50%. D: Class 3: Saphenous stump thrombosis with non-occlusive extension into deep vein of a cross-sectional area of more than 50%. A C B D 1.26±0.28 cm 2.06±1.25 cm 6 class 2, cm, 1.18 cm ±0.70 cm ±1.13 cm p=0.919 考察 7~9 EHIT EHIT class 1 class 4 5, EHIT THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 55

4 108 7, 10 3, EHIT class EHIT class 2 class Labropoulos EHIT class 1 EHIT class 1 1 class class class class class 1 EHIT class 2 3, 4 class 2, 3 1 EHIT 1, 6 EHIT 11 EHIT EHIT 1.26±0.28 cm 2.06±1.25 cm Mozes 12 class 1 脈管学 Vol. 55

5 109 4, 13 class 2 class 2, cm 1.18 cm class 結論謝辞利益相反文献 Labropoulos N, Bishawi M, Gasparis A, et al: Great saphenous vein stump thrombosis after harvesting for coronary artery bypass graft surgery. Phlebology 2014; 29: ; 14: ; 22: Kabnick LS, Ombrelino M, Agis H, et al: Endovenous heat induced thrombosis (EHIT) following endovenous vein obliteration: to treat or not to treat? A new thrombotic classification. 18th Annual Meeting American Venous Forum. February , Miami, Florida 6 Endovenous heat-induced thrombus (EHIT). Thrombosis 2013; 8: nm 2012; 21: nm radial 2ring fiber 2015; 26: ; 25: Marsh P, Price BA, Holdstock J, et al: Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc Surg 2010; 40: Hingorani AP, Ascher E, Markevich N, et al: Deep venous thrombosis after radiofrequency ablation of greater saphenous vein: a word of caution. J Vasc Surg 2004; 40: Mozes G, Kalra M, Carmo M, et al: Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques. J Vasc Surg 2005; 41: Winterborn RJ, Campbell WB, Heather BP, et al: The management of short saphenous varicose veins: a survey of the members of the vascular surgical society of Great Britain and Ireland. Eur J Vasc Endovasc Surg 2004; 28: Sutton PA, El-Dhuwaib Y, El-Duhwaib Y, et al: The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics. Ann R Coll Surg Engl 2012; 94: THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 55

6 110 Thrombosis of Saphenous Vein Stump after Varicose Vein Surgery Hiroto Rikimaru Department of Vascular Surgery, Tome City Hospital, Miyagi, Japan Key words: saphenous vein surgery, saphenous vein stump, endovenous heat-induced thrombosis (EHIT), varicose vein, deep vein thrombosis We evaluated the extension of thrombus formed in the proximal stump of saphenous vein on day 6, 4 weeks, and 16 weeks after saphenous vein surgery from July 2013 to March 2014 (18 patients, 29 limbs, 31 stumps), using color Doppler echo. Extension of each thrombus was classified as endovenous heat-induced thrombosis (EHIT). Twenty-seven stumps (87.1%) formed thrombus and only four (12.9%) stumps remained without thrombus on day 6 after surgery. One stump formed thrombus EHIT class 2, and another one stump formed thrombus EHIT class 3. The rest of the 25 stumps formed thrombus EHIT class 1. No further extension of thrombus was found on 4 weeks and 16 weeks after surgery. The rate of thrombus formed in the proximal stump of saphenous vein after conventional surgery is relatively higher than that of after thermoablation techniques. Further study is needed to investigate adequate evaluation and appropriate therapy for stump thrombosis after varicose vein surgery. (J Jpn Coll Angiol 2015; 55: ) Online publication August 10, 2015 脈管学 Vol. 55

Table 1 Patients preoperative characteristics Group LA group SR group No. of patients/legs 137/166 441/531 Age(yr), mean (range) 61.5 (23 82) 62.2 (20

Table 1 Patients preoperative characteristics Group LA group SR group No. of patients/legs 137/166 441/531 Age(yr), mean (range) 61.5 (23 82) 62.2 (20 Online publication January 14, 2011 原著第 50 回総会シンポジウム 6 日本静脈学会 :ここまで来た下肢静脈瘤治療下肢静脈瘤に対する血管内レーザー治療の適応高位結紮術をするなら抜去術でもよいのではないか要旨 : endovenous laser ablation EVLA)

脈管学55巻7号 pp

脈管学55巻7号　pp