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Varicer i benen

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Sakkunnig:

Definition:
Utvidgade, slingrande ytliga vener med insufficienta klaffar benen
Förekomst:
Finns hos 20–30 % av befolkningen, frekvensen ökar med åldern.
Symtom:
Synliga vener, eventuellt obehag, tyngdkänsla, ödem, hudförändringar och bensår. Sällan smärtor.
Kliniska fynd:
Vid undersökning ses utvidgade, slingrande vener med sviktande klaffunktion.
Diagnostik:
Duplex-ultraljud kan bekräfta venös insufficiens.
Behandling:
Ödem och tyngdkänsla i benet brukar minska med kompressionsstrumpa. Kirurgisk behandling är indicerat vid hudförändringar och/eller sår och samtidigt påvisad insufficiens i vena magna eller parva.
  1. Jones RH, Carek PJ. Management of varicose veins. Am Fam Physician 2008; 78: 1289-94. PMID: 19069022 PubMed  
  2. Ekløf B, Rutherford RB, Bergan JJ, et al. Revision of the CEAP classification for chronic venous disorders: Consensus statement. J Vasc Surg 2004; 40: 1248-52. doi:10.1016/j.jvs.2004.09.027 DOI  
  3. Piazza G. Varicose veins. Circulation. 2014 Aug 12. 130 (7):582-7. PMID: 25114187 PubMed  
  4. Bergan JJ, Sparks SR, Owens EL, Kumins NH. Growing the vascular surgical practice: venous disorders. Cardiovasc Surg 2001; 9: 431-5. PubMed  
  5. Sadick NS. Advances in the treatment of varicose veins: ambulatory phlebectomy, foam sclerotherapy, endovascular laser, and radiofrequency closure. Dermatol Clin 2005; 23: 443-55. PubMed  
  6. Bergan JJ, Schmid-Schönbein GW, Smith PD, Nicolaides AN, Boisseau MR, Eklof B. Chronic venous disease. N Engl J Med 2006; 355: 488-98. New England Journal of Medicine  
  7. Clarke GH, Vaskedis SN, Hobbs JT, Nicolaides AN. Venous wall function in the pathogenesis of varicose veins. Surgery 1992; 111: 402-8. Surgery  
  8. Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes GFR. Lifestyle factors and the risk of varicose veins. J Clin Epidemiol 2003; 56: 171-9. PubMed  
  9. Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol 2005; 15: 175-84. PubMed  
  10. Campbell WB, Decaluwe H, MacIntyre J, Thompson JF, Cowan AR. Most patents with varicose veins have fears or concerns about the future, in addition to their presenting symptoms. Eur J Vasc Endovasc Surg 2006; 31: 332-4. PubMed  
  11. Teruya TH, Ballard JL. New approaches for the treatment of varicose veins. Surg Clin North Am 2004; 84: 1397-1417. PubMed  
  12. Bradbury A, Evans C, Lee A, Rukley CV, Fowkes FGR. What are the symptoms of varicose veins? Edinburgh ven study cross sectional population survey. BMJ 1999; 318: 353-6 British Medical Journal  
  13. Smith JJ, Brown L, Greenhalgh R, Davies AH. Randomised Trial of Pre-operative Colur Duplex Marking in Primary Varicose Vein surgery: Outcome is not improved. Eur J Vasc Endovasc Surg 2002; 23: 336-43. PubMed  
  14. Santler B, Goerge T. Chronic venous insufficiency - a review of pathophysiology, diagnosis, and treatment. J Dtsch Dermatol Ges. 2017;15(5):538-556. PMID: 28485865 PubMed  
  15. van den Bos R, Arends L, Kockaert M, et al. Endovenous therapies of lower extremity varicosities: a meta-analysis. J Vasc Surg. 2009 Jan;49(1):230-9. PMID: 18692348 PubMed  
  16. Brittenden J, Cooper D, Dimitrova M, et al. Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. N Engl J Med 2019; 381: 912-22. pmid:31483962 PubMed  
  17. Shingler S, Robertson L, Boghossian S, Stewart M. Compression stockings for the initial treatment of varicose veins in patients without venous ulceration. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD008819. DOI: 10.1002/14651858.CD008819.pub3 DOI  
  18. Michaels JA, Brazier JE, Campbell WB, MacIntyre JB, Palfreyman SJ, Ratcliffe J. Randomised controlled trial comparing surgery with conservative treatment for uncomplicated varicose veins. Br J Surg 2006; 93: 175-81. PubMed  
  19. Ratcliffe J, Brazier JE, Campbell WB, Palfreyman S, MacIntyre JB, Michaels JA. Cost effectiveness analysis of surgery versus conservative treatment for uncomplicated varicose veins in a randomised controlled trial. Br J Surg 2006; 93: 182-6. PubMed  
  20. Davies HO, Popplewell M, Darvall K, et al. A review of randomised controlled trials comparing ultrasound-guided foam sclerotherapy with endothermal ablation for the treatment of great saphenous varicose veins. Phlebology. 2016 May;31(4):234-40. PMID: 26163507. PubMed  
  21. Sam RC, Silverman SH, Bradbury AW. Review. Nerve Injuries and Varicose Vein Surgery. Eur J Vasc Endovasc Surg 2004; 27: 113-20. PubMed  
  22. Kjeld T, Bækgaard N. Recidiv efter operation for varicer i vena saphena magna-området. Ugeskr Læger 2003; 165: 3009-13. PubMed  
  23. Klitfod L, Bækgaard N. Behandling af recidivvaricer i saphena magna-gebetet. Ugeskr Læger 2003;165:3013-5. PubMed  
  24. Rass K, Frings N, Glowacki P, et al. Comparable effectiveness of endovenous laser ablation and high ligation with stripping of the great saphenous vein. Arch Dermatol 2011; : doi:10/1001/archdermatol.2011.272.
  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet