Jongyoung Oh

Jongyoung Oh

Purpose: The purpose of this study is to compare air-plethy-smogram results between primary varicose vein and venous ulcer patients who had hemodynamic reflux only in great saphenous vein (GSV) pathology and also differentiate the morphologic characteristics of sapheno-femoral junction with duplex scan. Method: Patients who had pathology other than primary reflux of GSV was excluded as thrombus, deep vein path-ology. Group 1 for primary varicose vein, group 2 for venous ulcer patients and each was 28 patients equally. Standard protocol for air-plethysmogram was done and the diameter of GSV (GSVD), SFJ, femoral vein (FVD) and the ratio of each value-GSV/FV (GFDR) and SFJ/FV (JFDR)- were measured by color-flow duplex scanning. Result: Venous filling index (VFI) showed statistically sig-nificance between two groups which was 4.89±0.64 in group 2 and 3.21±0.35 in group (P value 0.02). But other para-meter ejection fraction (EF), and residual volume fraction (RVF) was not different significantly in two groups. The mean value of great saphenous vein, femoral vein and sapheno- femoral junction was showed no differences. Conclusion: VFI of air-plethysmogram was considered signi-ficant differentiate parameter between primary varicose vein and venous ulcer origin GSV reflux. And it could be consi-dered as prognostic parameter for venous ulcer. There is no size differences in GSV, sapheno-femoral junction. It means there is more than anatomic factor in progression of chronic venous disease.

Purpose: The purpose of this study was to know the changes of sapheno-femoral confluence after great saphenous vein stripping to treat varicose vein.
Method: From June 2007 to April 2008, 117 patients underwent clinical review, preoperative duplex scan and saphenofemoral ligation with great saphenous vein (GSV) stripping to treat varicose vein. We checked the size, reflux and neovascularization by duplex scan at 1 month to 12 months postoperatively (mean time: 223.88±120.99 days).
Result: A cumulative total of 33 saphenofemoral confluences (28 patients, women: 19 patients) were studied. There were no significant difference between preoperative and postoperative saphenofemoral confluences in duplex scan (for example: the size of femoral vein, saphenous vein and sapheno- femoral junction). In preoperative duplex scan, there were 21 reflux positive tributaries. After operation (high ligation and GSV stripping), there were 4 reflux positive tributaries.
Conclusion: There was no change in size of saphenofemoral confluences. There was no evidence of recurrence in reflux tests. We could find neovascularization at sapheno-femoral confluence. But there was no recurrent varicose vein. To know the relation of recurrence with neovascularization, further studies are needed. (J Korean Soc Phlebol 2009;8: 1-4)

Purpose: The care of varicose vein is removal or ablation of pathologic vessels. It can be achieved by removing surgically or obliterating with sclerotherapy. The sclerosing agents first used, however, were too strong to use as a practical protocol for such veins. After the introduction of less toxic sclerosing agents, now it is a safe, easy, and reliable treatment for varicose veins. We have tried the clinical research with sclerotherapy only patients, to identify the clinical indication of sclerotherapy for primary varicose vein.
Method: We reviewed 1,583 patients with primary varicose vein who were treated with sclerotherapy at Dept of Surg, Kangbuk Samsung Hosp, SungKyunKwan University College of Medicine, from January 1996 to December 2007.
Result: The distribution of age were the first 4th decade (40.2%) followed by 5th decade, 3rd decade, the ratio of sex were more prevalent in female than male (1：9)
Sx & sign were showed cosmetic problem (60.5%) in most patients, followed by pain (18.8%), swelling (18.1%), heaviness. The duration of illness were over 5 yrs in most patients. The associating facto were correlated with pregnancy in most female (33.7%), and family History (7%), long standing posture, DM, HTN, Trauma. The size of varicose vein were type II in case 1066 (67.4%) followed by type III (27.4%), type I (4%), type IV (1%) according to the classification by Dr. Weiss. The frequency of injection were 2∼4 times (70.2%) in most patients. During 4 months of injection therapy, almost varicose veins were disappeared. Complication after injection were Hyperpigmentation 38 cases, followed by skin necrosis 16 cases in 25 cellulitis in 8 cases. Recurrence rate after injection were extremely rare.
Conclusion: The sclerotherapy of telangiectasia (Type I, II) is highly effective. Sclerotherapy based on knowledge of venous anatomy, selection of sclerosing agents, is successful treatment of varicose vein. (J Korean Soc Phlebol 2009; 8:5-8)

Since 2000, according to the recognition of varicose vein as a disease, the number of patients was increased by about three-times and the number of surgery gradually increases annually. Accordingly, financial expenses of medical insur-ance have become excessive and rising medical costs have been a problem. Eventually, HIRA (Health Insurance Review & Assessment service) evaluates the adequacy of surgery and imposes some restriction. The operator must check the venous-reflux of varicose vein by Duplex ultrasonography. Above all, classification of operation title must be made in detail and the criteria of adequacy also must be reviewed for appropriate compensation of varicose vein surgery. (Korean J Phlebology 2014;13:1-4)

Varicose vein (v.v) shows popular prevalence and needs for treatment is increasing. Endovenous laser therapy (EVLT) and radio-frequency ablation (EVRFA) is now recognized as the standard treatment modality for v.v because of various merits. After endovenous non-invasive treatment, remnant varicosity can be the problem. So simultaneous or later foam sclerotherapy or ambulatory microphlebectomy is now added in many EVLT/EVRFA patients. The effectiveness and necessity of additional treatment is debatable in the point of timing and choice of methods. However, it may be the trend to do the additional treatment for the EVLT/EVRFA patients of varicose vein. It is new and innovated treatment modality to do the foam sclerotherapy through endovenous approach using fluoroscopy. It shows more cure rate and less complication rate. Although it may be difficult to apply this treatment method in the entire institute to have the therapeutic clinics of varicose vein, it can open the field of treatment modality of varicose vein wider. And additional treatment for the EVLT/EVRFA is increasing and should be considered. (Korean J Phlebology 2014;13:10-14)

Purpose: The purpose of this study is to investigate the trends of C-class and clinical departments, which are commonly used in clinical practice, to verify classification accuracy, and to provide preventive data through them. Method: This study is conducted on outpatients who visited one of clinic in Busan for 1 year. A Chi-square test is performed to examine the relationship between the clinical classification of patients and actual reflux diagnosis. In addition, a linear by linear analysis is performed to verify the tendency. Result: As a result, the study found that the proportion of middle-aged women was high in diagnosing varicose veins. In addition, as the C-class increased, the proportion of varicose vein reflux diagnosis tended to statistically significant increase (Test for trend=4.822, p＜.05). Conclusion: When it comes to the diagnosis of CVD, it seems reasonable to apply the C-class to Koreans. Generally, there would be a tendency that perception of C1 class is decreased. However, there was a relation between C1 and reflux of GSV or SSV more than 92%. (Ann Phlebology 2017;15:1-4)

Chronic venous disorder (CVD) including varicose veins is very common health problem. The aim of this article is to introduce the classification of varicose veins and venous clinical severity scoring (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) as objective and subjective evaluation tools. CEAP (clinical, etiologic, anatomic, pathophysiologic) classification is basic descriptive classification of varicose veins. It was adopted worldwide to communicate between clinicians about CVD and serve a basis for more scientific analysis. VCSS is useful assessment method of severity evaluation of CVD. It can be very useful in results assessment quantitatively. VCSS was designed not to replace of CEAP classification but, to supplement it. AVVQ is patient- reported quality of life measurement system. It is a valid and reliable outcome measurement for patients with varicose veins. These classification & measurement systems, based on correct diagnosis, were also to serve as a systematic guide of patients with CVD as an orderly documentation system and to help for decision making of appropriate treatment. 

Background: The number of people suffering from varicose vein is continuously increasing, showing an average increase of 4.36% every year. This figure is higher than the average rate of increase in total diseases, which marks as 3.61% in the same period. Varicose vein is a chronic vein disease, which progresses continuously and possibly develop other various complications.
Methods: This study was conducted by examining 759 outpatients for 7 months at a varicose vein medical institution, located in Busan. Logistic regression was applied to analyze the relevance between the subjective symptoms of patients and venous reflux.
Results: Those feeling heaviness were 3.23 times (95% CI=1.65∼6.32) more likely to receive venous reflux diagnosis of varicose vein than those who do not, and those experiencing night cramp were 2.27 times (95% CI=1.28∼4.03) more likely to get the venous reflux.
Conclusion: The subjective symptoms of patients can be an indicator of the presence of an actual venous reflux. Thus, reinforcement of mediation actions such as education and campaigns to raise awareness of varicose vein is seen to be needed.