Research Article
Volume 7 Issue 1 - 2020
A Change of a Paradigm Under the Scope of a Cardiovascular Surgeon. Remodeling of the Great Saphenous Vein Instead of Ablation for Preservation of the Patient Anatomical Capital
Ferracani E*
Sanatorio Otamendi and Instituto Privado de Ultrasonido y LASER, Borges, CABA, Argentina
*Corresponding Author: Ferracani E, Sanatorio Otamendi and Instituto Privado de Ultrasonido y LASER, Borges, CABA, Argentina.
Received: November 11, 2019; Published: December 30, 2019


The presented work is an ongoing study by using a combined approach of sparing surgical techniques plus LASER 1470 nm for sparing the Great saphenous vein (GSV) at early hemodynamics stages.

Peak reflux Volume lower than 30cc by second, Total Reflux Volume (TRV) between 10 and 100 cc/s using low LASER LEED and no tumescence anesthesia for preservation of patient anatomical capital and the actual recovery value of this conduit for a future arterial bypass.

Keywords: Preservation Human Anatomic Capital; Great Saphenous Sparing Methods and Remodeling; Low LEED LASER Use


  1. Ferracani E. “Internal laser valvuloplasty and venous remodeling using 1470 laser. Initial experience. Flebologia”. Sociedad Argentina de flebologia y linfologia 3 (2013): 39-40. 
  2. Ferracani E. “Saphenous sparing laser modern options”. The Salvador University. CABA Argentina (comment to Gianesini et al, Veins and Lymphatics 2 (2013): e21and Veins and Lymphatics 4 (2015): 5246. Veins and Lymphatics 4 (2015): 553.
  3. Sergio Gianesini. “Vascular Disease Center”. University of Ferrara, Cona (FE), Italy Reply to: Saphenous sparing laser modern options (comment to Gianesini et al., Veins and Lymphatics 2 (2013): e21 and Veins and Lymphatics 4 (2015): 5246. 
  4. Seshadri Raju., et al. “Quantifying saphenous reflux”. Presented at the Twenty-sixth Annual. Meeting of the American Venous Forum, New Orleans, La (2014): 19-21. 
  5. Danielsson G., et al. “Venous function after restoring valve competence of the great saphenous vein”. Journal of Endovascular Therapy 10.2 (2003): 350-355. 
  6. Claude Franceschi et al. “CHIVA: hemodynamic concept, strategy and results”. International Angiology 35.1 (2016): 8- 30.
  7. Franceschi C. “Théorie et pratique de la cure conservatrice et hémodynamique de l’insuffisance veineuse en ambulatoire”. Precy-sous-Thil: Editions de l’Armançon (1988). 
  8. Franceschi C. “Dynamic fractionizing of hydrostatic pressure, closed and open shunts and vicarious varicose evolution: how these concepts made the treatment of varices evolve?” Phlebologie 56 (2003): 61.
  9. Franceschi C. “La cure hemodynamique de l’insuffisance veineuse en ambulatoire”. Journal des Maladies Vasculaires 17 (1992): 291-300.
  10. Zamboni P and Escribano JM. “Regarding ‘Reflux elimination without any ablation or disconnection of the saphenous vein. A haemodynamic model for venous surgery’ and ‘Durability of reflux-elimination by a minimal invasive CHIVA procedure on patients with varicose veins. A 3-year prospective case study”. European Journal of Vascular and Endovascular Surgery 28 (2004): 567.
  11. Lee MD et al. “UIP Hemodynamic Consensus”. International Angiology 35.3 (2016): 262-265. 
  12. Navarro TP., et al. “Is total abolishment of great saphenous reflux in the invasive treatment of superficial chronic venous insufficiency always necessary?” International Angiology 28.1 (2009): 4-11.
  13. Cappelli M., et al. “Hemodynamics of the sapheno-femoral complex: an operational diagnosis of proximal femoral valve function”. International Angiology 25 (2006): 356 –360. 
  14. Vincent JR., et al. “Failure of micro venous valves in small superficial veins is a key to the skin changes of venous insufficiency”. Journal of Vascular Surgery 54.6 (2011): 62S-69S.
  15. Jee Won Chang MD., et al. “Expression of Matrix Metalloproteinase-2 and -13 and Tissue Inhibitor of Metalloproteinase-4 in Varicose Veins Korean”. The Journal of Thoracic and Cardiovascular Surgery 44 (2011): 387-391. 
  16. W Schmid - Schönbein. “Triggering mechanisms of venous valve incompetence. The Venous Valve and Primary Chronic Venous Disease”. Medicographia 30.2 (2008). 
  17. Coleridge-Smith P., et al. “Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs – UIP consensus document. Part I. Basic principles”. European Journal of Vascular and Endovascular Surgery 31 (2006): 83-92. 
  18. Labropoulos N., et al. “Primary superficial vein reflux with competent saphenous trunk”. European Journal of Vascular and Endovascular Surgery 18 (1999): 201-206. 
  19. Labropoulos N., et al. “Where does venous reflux start?”. Journal of Vascular Surgery. 26 (1997): 736-742. 
  20. TA Jawien MD. “Treatment of venous valve incompetence: past, current, and future. The Venous Valve and Primary Chronic Venous Disease”. Medicographi 30.2 (2008).
  21. Bar–Meir G. “Basics of fluid mechanics” (2011). 
  22. Takashi Yamaki MD. “Comparing Duplex Ultrasound Scanning Between the US and Abroad Department of Plastic and Reconstructive Surgery”. Tokyo Women’s Medical University. ACP Annual Congress Presentations (2011). 
  23. Yamaki T., et al. “High peak reflux velocity is a strong predictor of advanced post-thrombotic sequelae”. Journal of Thrombosis and Haemostasis 5 (2007): 305-312. 
  24. Yamaki T., et al. “Advanced chronic insufficiency is associated with increased calf muscle deoxygenation”. European Journal of Vascular and Endovascular Surgery 39 (2010): 787-794. 
  25. Gloviczki P Md and Yim Huang Md. “Saphenous vs non-saphenous varicose vein therapy: is there a role for saphenous preservation in the presence of saphenous reflux”. International Vein Congress (2015).
  26. Parikov M. “Endovenous laser ablation damage of venous Wall treated in vivo with Radial fiber and 1470nm diode Laser”. XVII UIP BOSTON 32.1 (2013): 159. 
  27. José Martínez-Gonzáleza and Lina Badimona. “Reendotelización, engrosamiento intimal y remodelado vascular. ¿Un denominador común?” Revista Española de Cardiología 53.11 (2000): 1425-1427.  
  28. Cross KS., et al. “Long-term human vein graft contractility y and morphology: a functional and histopathological study of retrieved coronary vein grafts”. British Journal of Surgery 81.5 (1994): 699-705. 
  29. Pittaluga Paul MD., et al. “Preservation of The Saphenous Vein in Patients with Varicose Veins”.
  30. Cestmir Recek. “The hemodynamic paradox as a trigger phenomenon of recurrent venous reflux disease with varicose veins”. International Journal of Angiology. 21 .3 (2012): 181-186. 
  31. Bellmunt-Montoya S., et al. “CHIVA method for the treatment of chronic venous insufficiency”. Cochrane Database System Reviews 6 (2013): CD009648. 
  32. S Bellmunt-Montoya. “CHIVA method for the treatment of chronic venous insufficiency”. Cochrane Database System Reviews (2015). 
  33. Pannier F Rabe., et al. “Mid-term results following endovenous laser ablation (EVLA) of saphenous veins with a 980 nm diode laser”. International Angiology 27.6 (2008): 475-481.
  34. Renate van den Bos D., et al. “The Netherlands Endovenous therapies of lower extremity varicosities: A meta-analysis”.
  35. Spreafico G., et al. “Laser Saphenous Ablations in More Than 1,000 Limbs With Long-Term Duplex Examination Follow-Up”. Annals of Vascular Surgery 25.1 (2011): 71-78.
  36. REVATA.
  37. Margaret Tracci MD. Save the saphenous. Why all patients with saphenous reflux don t need an ablation. Annual current concepts intravascular therapies Virginia Beach 27 (2018).
  38. Dreifalt M., et al. “The no Touch saphenous vein as the preferred second conduit for coronary artery bypass grafting Department of Cardiovascular Surgery, Univesrsity Hospital. Orebro Swede”. The Annals of Thoracic Surgery 96. 1 (2013): 105-111.
  39. Samano N., et al. “The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial. Trial Registration Clinical Trials. Gov NCT01686100”. The American Association for Thoracic Surgery 150.4 (2015): 880-888. 
  40. Papakonstantinou NA., et al. “Novel No touch technique of saphenous vein harvesting: Is great graft patency rate provided?”. The Journal of Thoracic and Cardiovascular Surgery 150.4 (2015): 880-888. 
  41. Marcello Romiti MD., et al. “Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia”. Journal of Vascular Surgery 47 (2008): 975-981. 
  42. Maximiano Albers MD., et al. “Meta-analysis of popliteal-to-distal vein bypassgrafts for critical ischemia”. Journal of Vascular Surgery 43 (2006): 498-503. 
  43. Ziza V., et al. “Outcomes of cold-stored venous allograft for below-knee bypasses in patients with critical limb ischemia”. Journal of Vascular Surgery 62.4 (2015): 974-983. 
Citation: Ferracani E. “A Change of a Paradigm Under the Scope of a Cardiovascular Surgeon. Remodeling of the Great Saphenous Vein Instead of Ablation for Preservation of the Patient Anatomical Capital”. EC Cardiology 7.1 (2020): 01-17.

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