Quantifizierung des effekts von varizenoperationen auf die venöse hämodynamik mittels des veno-arteriellen flow-index (VAFI)

Aim: To quantify the hemodynomic outcome after venous surgery by measurement of the volume flow in the common femoral vein and artery (VSV, ASV). Methods: 46 patients with varicose veins were included. 22 patients had a complete varicose of the great saphenous vein (GSV): 12 patients (collective 1) underwent crossectomy and stripping of the GSV and 10 patients (collective 2) only agreed to a partial operation below the knee. 24 patients with truncal varicose of the GSV (collective 3) had selective phlebectomy. VSV and ASV were measured under standardiszed conditions by duplex sonography. The quotient of VSV and ASV (VAFI = veno-arterial flow index) was calculated. The assessments were performed preoperatively, 2 and 8 weeks after venous surgery. A colour-coded duplex sconner (Apogee 800, Advanced Technology Laboratories) with 7.5 MHz linear array was used. Results: Preoperatively the mean VSV of all 46 patients was 0.42 l/min, 2 weeks after surgery 0.30 l/min and 0.28 l/min, 8 weeks later (p<0.001). ASV did not change significantly. In all patients VAFI decreased from 1.19 to 0.86 after 2 weeks and 0.77 after 8 weeks (p<0.001). The 3 collectives showed differences concerning the value of VAFI. Collective 1:1.28 preoperatively, 0.83 and 0.73 postoperatively; collective 2:1.34 before and 1.01 and 0.87 after surgery; collective 3:1.02 preoperatively and 0.86 and 0.73 2 and 8 weeks later. Conclusion: Venous surgery induces a significant reduction of VSV and VAFI. To quantify the hemodynamic effect of the operation VAFI would be the better parameter.