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August 1960

Arteriovenous Anastomoses and Varicose Veins: Observations with the Operation Microscope

Author Affiliations

Iowa City
From the Department of Surgery, College of Medicine, State University of Iowa.

Arch Surg. 1960;81(2):299-310. doi:10.1001/archsurg.1960.01300020127019

In this paper I propose to report certain observations on patients treated for varicose veins; to describe possible arteriovenous anastomoses (AVA) found in this condition, and to suggest that these tiny shunts are concerned in the development of varices. In addition, I will refer briefly to the use of the operation microscope for explorations during surgical procedures.

Method and Material  Studies were made upon 14 unselected patients with varicose veins. All were treated by ligation and stripping except one woman who was seven months pregnant. All had preoperative studies which included a clinical history, physical examination, routine laboratory procedures and special tests for venous valvular competency. All definitive operations were carried out under spinal or general anesthesia with the patient in Trendelenberg position to minimize bleeding from superficial veins.* After careful dissection of the sites designated for detailed study, photographs and sketches were made and the observations were supplemented by