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A NEW TEST FOR EVALUATING CIRCULATION IN THE VENOUS SYSTEM OF THE LOWER EXTREMITY AFFECTED BY VARICOSITIES

A NEW TEST FOR EVALUATING CIRCULATION IN THE VENOUS SYSTEM OF THE LOWER EXTREMITY AFFECTED BY... Abstract It has been forty-five years since Trendelenburg1 (1891) reemphasized the most important factor concerned in the disturbance in function of varicose veins of the lower extremity. In this paper he demonstrated incompetence of the valves of the internal saphenous vein and the reversal of circulation that results, i. e., the peripheral flow of blood in the superficial venous system. Moreover, he popularized an operation2 which is the most direct attack on the physiopathologic factor, namely, ligation and section of the long saphenous vein to prevent the blood from spilling from above through the saphenous vein into the varicosities. The good results he obtained with this operation in a large series of cases were later reported by Perthes.3 Since that time much has been added to the knowledge of individual methods and combinations of methods for the treatment of varicose veins, and the problem has been shown to References 1. Trendelenburg, F.: Ueber die Unterbindung der Vena saphena magna bei Unterschenkelvaricen , Beitr. z. klin. Chir. 7:195, 1891. 2. According to Trendelenburg, others, including Ambroïse Paré, had ligated the internal saphenous vein for relief from varicosities. 3. Perthes, Georg: Ueber die Operation der Unterschenkelvaricen nach Trendelenburg , Deutsche med. Wchnschr. 1:253, 1895.Crossref 4. Sir Benjamin Brodie ( Lectures Illustrative of Various Subjects in Pathology and Surgery , London, Longmans, 1846, vol. 7) 5. Moro, G.: Ueber die Pathogenese und die zweckmässigste Behandlung der Krampfadern der unteren Extremitäten , Beitr. z. klin. Chir. 71:420, 1910. 6. Homans, J.: The Operative Treatment of Varicose Veins and Ulcers Based on a Classification of These Lesions , Surg., Gynec. & Obst. 22:143, 1916. 7. By ligation we do not mean that ligation alone is our method of treatment. We always use injection in conjunction with ligation in the cases in which we elect to ligate the saphenous vein. Moreover, sometimes we ligate veins other than the main stem of the saphenous vein. The present discussion is limited to indications arising from the test. Ligation means section and ligation of the distal and proximal segments. 8. Homans, J.: The Operative Treatment of Varicose Veins, Varicose Ulcers, and Phlebitis , New England J. Med. 200:965, 1929 9. de Takáts, G.: Ambulatory Ligation of the Saphenous Vein , J. A. M. A. 94:1194 ( (April 19) ) 1930. 10. De Takáts, G., and Quillin, L.: Ligation of the Saphenous Vein: A Report on Two Hundred Ambulatory Operations , Arch. Surg. 26:72 ( (Jan.) ) 1933. 11. Faxon, H. H.: Treatment of Varicosities: Preliminary High Ligation of the Internal Saphenous Vein with the Injection of Sclerosing Solutions , Arch. Surg. 29:794 ( (Nov.) ) 1934. 12. Edwards, E. A.: The Treatment of Varicose Veins , Surg., Gynec. & Obst. 59:916, 1934. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

A NEW TEST FOR EVALUATING CIRCULATION IN THE VENOUS SYSTEM OF THE LOWER EXTREMITY AFFECTED BY VARICOSITIES

Archives of Surgery , Volume 33 (3) – Sep 1, 1936

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Publisher
American Medical Association
Copyright
Copyright © 1936 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1936.01190030132007
Publisher site
See Article on Publisher Site

Abstract

Abstract It has been forty-five years since Trendelenburg1 (1891) reemphasized the most important factor concerned in the disturbance in function of varicose veins of the lower extremity. In this paper he demonstrated incompetence of the valves of the internal saphenous vein and the reversal of circulation that results, i. e., the peripheral flow of blood in the superficial venous system. Moreover, he popularized an operation2 which is the most direct attack on the physiopathologic factor, namely, ligation and section of the long saphenous vein to prevent the blood from spilling from above through the saphenous vein into the varicosities. The good results he obtained with this operation in a large series of cases were later reported by Perthes.3 Since that time much has been added to the knowledge of individual methods and combinations of methods for the treatment of varicose veins, and the problem has been shown to References 1. Trendelenburg, F.: Ueber die Unterbindung der Vena saphena magna bei Unterschenkelvaricen , Beitr. z. klin. Chir. 7:195, 1891. 2. According to Trendelenburg, others, including Ambroïse Paré, had ligated the internal saphenous vein for relief from varicosities. 3. Perthes, Georg: Ueber die Operation der Unterschenkelvaricen nach Trendelenburg , Deutsche med. Wchnschr. 1:253, 1895.Crossref 4. Sir Benjamin Brodie ( Lectures Illustrative of Various Subjects in Pathology and Surgery , London, Longmans, 1846, vol. 7) 5. Moro, G.: Ueber die Pathogenese und die zweckmässigste Behandlung der Krampfadern der unteren Extremitäten , Beitr. z. klin. Chir. 71:420, 1910. 6. Homans, J.: The Operative Treatment of Varicose Veins and Ulcers Based on a Classification of These Lesions , Surg., Gynec. & Obst. 22:143, 1916. 7. By ligation we do not mean that ligation alone is our method of treatment. We always use injection in conjunction with ligation in the cases in which we elect to ligate the saphenous vein. Moreover, sometimes we ligate veins other than the main stem of the saphenous vein. The present discussion is limited to indications arising from the test. Ligation means section and ligation of the distal and proximal segments. 8. Homans, J.: The Operative Treatment of Varicose Veins, Varicose Ulcers, and Phlebitis , New England J. Med. 200:965, 1929 9. de Takáts, G.: Ambulatory Ligation of the Saphenous Vein , J. A. M. A. 94:1194 ( (April 19) ) 1930. 10. De Takáts, G., and Quillin, L.: Ligation of the Saphenous Vein: A Report on Two Hundred Ambulatory Operations , Arch. Surg. 26:72 ( (Jan.) ) 1933. 11. Faxon, H. H.: Treatment of Varicosities: Preliminary High Ligation of the Internal Saphenous Vein with the Injection of Sclerosing Solutions , Arch. Surg. 29:794 ( (Nov.) ) 1934. 12. Edwards, E. A.: The Treatment of Varicose Veins , Surg., Gynec. & Obst. 59:916, 1934.

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1936

References