Contrasting Effects of Varicose Vein Surgery on Endothelial-dependent and -independent Cutaneous Vasodilation in the Perimalleolar Region

To evaluate the effects of varicose vein surgery on cutaneous microvascular perfusion and vasodilator responses to acetylcholine (Ach) and sodium nitroprusside (SNP) in the gaiter area of patients with great saphenous vein insufficiency. Twenty-nine patients with isolated great saphenous vein incomp...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2006-04, Vol.31 (4), p.434-438
Main Authors: Klonizakis, M., Yeung, J.M.-C., Lingam, K., Nash, J.R., Manning, G., Donnelly, R.
Format: Article
Language:English
Subjects:
Acetylcholine - pharmacology
Ankle - blood supply
Endothelial function
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
Female
Humans
Iontophoresis
Laser Doppler
Male
Microvascular
Middle Aged
Nitroprusside - pharmacology
Posture
Saphenous Vein
Skin - blood supply
Sodium nitroprusside
Varicose veins
Varicose Veins - physiopathology
Varicose Veins - surgery
Vasodilation - physiology
Vasodilator Agents - pharmacology
Venous Insufficiency - physiopathology
Venous Insufficiency - surgery
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Summary:To evaluate the effects of varicose vein surgery on cutaneous microvascular perfusion and vasodilator responses to acetylcholine (Ach) and sodium nitroprusside (SNP) in the gaiter area of patients with great saphenous vein insufficiency. Twenty-nine patients with isolated great saphenous vein incompetence attended three study mornings (before surgery, and 6–8 weeks and 6 months after sapheno-femoral ligation+partial stripping) during which cutaneous microvascular responses were measured in the supine and standing positions using laser Doppler fluximetry (LDF) combined with incremental-dose iontophoretic administration of endothelial-dependent (Ach) and -independent (SNP) vasodilators. Varicose vein surgery had no significant effect on baseline cutaneous perfusion or the microvascular response to Ach: e.g. peak vasodilator responses to the 1000 μC stimulus were mean 58 SEM 7, 64 SEM 6 and 65 SEM 7 PU on the pre-operative, 6–8 weeks and 6 months assessments. In contrast, the corresponding responses to SNP were significantly increased following surgery: e.g. at 2000 μC, mean 63 SEM 9, 142 SEM 4 and 157 SEM 9 PU ( p
ISSN:1078-5884
1532-2165
DOI:10.1016/j.ejvs.2005.10.017