Surgical Treatment for Congenital Venous Malformations in the Lower Limb

(Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan and Department of Cardiovascular Surgery, Akane Foundation Tsuchiya General Hospital, Hiroshima, Japan)

Fujihiro Oka Kazunobu Nishimura Koji Ueyama
Atsushi Iwakura Senri Miwa Michiya Hanyuu
Takaaki Koshiji Masashi Komeda
Four patients, 13 to 53 years old, with congenital venous malformation including Klippel-Trenaunay syndrome underwent surgical treatment followed by sclerotherapy. They developed marked dilatation of varicose veins with spots, and complained of pain, dullness, and bleeding. Two patients also had hypertrophy of the diseased leg. Phlebography and color Doppler ultrasonography were performed in all patients to precisely determine the abnormal vein and incompetent communicating veins which were then resected and/or ligated with minimal skin incision. In two patients, additional ligation of incompetent communicating veins was necessary. One to two weeks after surgical therapy, sclerotherapy was performed with 1-2% polidocanol. Symptoms improved after treatment, even in a patient with claudication before operation. Surgical therapy for congenital venous malformation was feasible and satisfactory, with the aid of meticulous identification of abnormal veins and communicating veins by not only phlebography but color Doppler ultrasonography.
@Jpn. J. Cardiovasc. Surg. 29: 68-71(2000)