Table 4.
Combined total of complications/side effects of open operative treatment of varicose veins (absolute/%): 151,720 legs operated, nine studies, 1983–2013
| Author- | All | Helmig | Balzer | Hagmüller | Nüllen | Frings | Critchley | Hofer | Noppeney | Papapostolou | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Year | – | 1983 [258] | 1983 [282] | 1992 [257] | 1995 [283] | 1995 [284] | 1997 [265] | 2001 [259] | 2005 [153] | 2013 [252] | |||||||||
| Number of “cases” | – | – | 25,457 | – | – | 47,057 | – | – | – | – | |||||||||
| Patients | – | 13,024 | – | – | 1683 | – | 599 | 1094 | 36,323 | 841 | |||||||||
| Legs | – | 20,353 | – | 3300 | 1981 | – | 973 | 1590 | 49,939 | 1070 | |||||||||
| – | % | n | % | n | % | n | % | n | % | nn | % | nn | % | nn | % | nn | % | nn | % |
| Intraoperative/intraprocedural | |||||||||||||||||||
| Bleeding/Shock | 0.01–0.1 | 1 | 0.005 | 4 | 0.015 | – | – | 13 | 0.66 | – | – | – | – | – | – | – | – | – | – |
| Transfusion | 0.05 | – | – | – | – | – | – | – | – | – | – | – | – | – | – | 23 | 0.046 | – | – |
| Injury to large arteries | 0.01 | 1a | 0.005 | 3 | 0.012 | – | – | – | – | 1b | 0.002 | 1b | 0.10 | – | – | 1 | 0.002 | – | – |
| Injury to large veins | 0.01–0.1 | 10 | 0.049 | 2 | 0.008 | 1 | 0.03 | – | – | 4 | 0.009 | – | – | – | – | 21 | 0.042 | – | – |
|
Nerve damage – Motor |
0.01–0.1 | 2c | 0.010 | – | – | 1 | 0.03 | – | – | 3c | 0.006 | 1c | 0.10 | – | – | 6 | 0.012 | – | – |
| – Sensory | 0.2–6.6 | 43 | 0.21 | – | – | – | – | 95 | 4.8 | – | – | 64 | 6.58 | 18 | 1.13 | 48 | 0.096 | 34 | 3.18 |
| Postoperative/postprocedural | |||||||||||||||||||
| Secondary bleeding | 0.06–0.1 | – | – | 15 | 0.059 | – | – | 2 | 0.1 | – | – | – | – | – | – | – | – | – | – |
| Requiring revision | 0.13 | 26 | 0.13 | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – |
| Requiring transfusion | 0.06–0.21 | 42 | 0.21 | – | – | – | – | – | – | – | – | – | – | – | – | 32 | 0.06 | – | – |
| Haematoma | 0.6–2.0 | 130 | 0.64 | – | – | – | – | 35 | 1.77 | – | – | – | – | 30 | 1.89 | 585 | 1.17 | 6 | 0.56 |
| Puncture/surgical haematoma removal | 0.1 | 25 | 0.12 | – | – | – | – | – | – | – | – | – | – | – | – | – | – | 1 | 0.093 |
| Suffusion/ecchymosis | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – |
| Seroma | 1.4 | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | 15 | 1.4 |
| Wound infection | 0.1–2.8 | 25 | 0.12 | 13 | 0.051 | – | – | 1 | 0.05 | 72 | 0.153 | 27 | 2.77 | 21 | 1.32 | 387 | 0.78 | 23 | 2.15 |
| With revision | 0.22 | – | – | – | – | – | – | – | – | – | – | 2 | 0.21 | – | – | 115 | 0.23 | – | – |
| Wound healing disturbance | 0.05–1.38 | 232 | 1.14 | – | – | – | – | 1 | 0.05 | – | – | – | – | 22 | 1.38 | – | – | – | – |
| Pigmentation disturbance | 0.2 | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | – | 2 | 0.18 |
| Lymphatic fistula/cyst/oedema | 0.02–1.82 | 112 | 0.55 | 16 | 0.063 | – | – | 3 | 0.15 | – | – | 8 | 0.82 | 29 | 1.82 | – | – | – | – |
| Superficial vein thrombosis | 0.2–0.3 | – | – | – | – | – | – | – | – | – | 0.049 | 2 | 0.21 | – | – | 146 | 0.29 | 2 | 0.18 |
| Deep leg vein thrombosis | 0.03–0.24 | 11 | 0.05 | 7 | 0.027 | 8 | 0.24 | 2 | 0.1 | 23 | – | 3 | 0.31 | 2 | 0.13 | 39 | 0.08 | 1 | 0.093 |
| Lung embolism | 0.01–0.13 | 2 | 0.01 | 5 | 0.020 | 2 | 0.06 | – | – | 6 | 0.013 | 1 | 0.10 | 2 | 0.13 | 8 | 0.02 | – | – |
| Other complicationsd | 0.1–4.2 | 22 | 0.11 | – | – | – | – | 83 | 4.19 | – | – | 4 | 0.41 | – | – | 56 | 0.11 | 1 | 0.093 |
| Deathse | 0.004–0.023 | 2 | 0.005 | 1 | 0.004 | – | – | – | – | – | – | – | – | – | – | – | – | – | – |
Injury to large arteries/veins:
aVery thin female patient
bDuring revision of saphenofemoral junction (SFJ) treatment
cDuring saphenopopliteal junction (SPJ) operation, some with course of the nerve in the operation region described as complicated
dOther complications: Helmig: increase of a preexisting swelling (during diagnosis of possible deep vein thrombosis [DVT]); Nüllen: severe oedema; Papapostolou: suture granuloma; Critchley: blisters due to compression bandage, breast infection (?); Noppeney: other intraoperative complications
eDeaths: Balzer: lung embolism; Helmig: 1 × ventricular fibrillation under general anaesthesia, 1 × warfarin bleeding after 9 months (due to thrombus)