Dietmar Stenger - Academia.edu (original) (raw)

Uploads

Papers by Dietmar Stenger

Research paper thumbnail of Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein

Journal of Vascular Surgery, 2006

Objective: To identify patient and physician-controlled treatment variables that might predict th... more Objective: To identify patient and physician-controlled treatment variables that might predict the persistence or redevelopment of saphenofemoral junction (SFJ) reflux. Methods: Thirteen European centers, with substantial lower extremity venous disease practices, examined their experience with SFJ ligation and GSV stripping for primary varicose veins in patients followed for >2 years, entering their data into a protocol-driven matrix that stipulated duplex Doppler imaging as an essential component of follow-up examinations and required a complete review of all peri-operative examinations, as well as all operative procedure and anesthesia notes. Matrix entries were centrally audited for consistency and credibility, and queried for correction or clarification before being accepted into the study database. Presence or absence of Doppler-detectable SFJ reflux was the dependent variable and principal outcome measure. Results: Among 1,638 limbs, 315 (19.2%) had SFJ reflux. After adjustment for follow-up length and imputing for missing values, multivariable analysis identified seven significant predictors. Ultrasonic groin mapping (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.20 to 0.40) and <3-cm groin incisions at or immediately below the groin crease (OR, 0.50; 95% CI, 0.32 to 0.78) were both uniquely associated with diminished probability of follow-up SFJ reflux. Prior parity (OR, 2.69; 95% CI, 1.45 to 4.97), body mass index >29 kg/m 2 (OR, 1.65; 95% CI, 1.12 to 2.43), <3-cm suprainguinal incisions (OR, 3.71; 95% CI, 1.70 to 5.88), stripping to the ankle (OR, 2.43; 95% CI, 1.71 to 3.46), and interim pregnancy during follow-up (OR, 4.74; 95% CI, 2.47 to 9.12), were each independent predictors of a greater probability of having SFJ reflux. Conclusions: The findings suggest that ultrasound groin mapping, reticence for short suprainguinal or longer groin incisions and extended stripping, and counseling women about the effect of future pregnancy are prudent clinical choices, especially for obese or previously parous patients.

Research paper thumbnail of Offene Varizenchirurgie – wann ambulant, wann stationär?

Phlebologie, 2020

Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimm... more Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.

Research paper thumbnail of Crossectomy (flush ligation) of small saphenous vein Die Krossektomie der V. saphena parva

A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom car... more A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom carried out in literature. The two authors thoroughly describe the technical procedure of a high, flush ligation of the saphenopopliteal junction (SPJ). The risks and problems of the surgery are described and illustrated. A retrospective cohort study with the aim of conducting a flat small saphenous crossectomy yielded the following findings in 187 operated legs: small saphenous remainder stumps with clinically relevant recurrence in 2.1 %, small saphenous neovasculature with clinically relevant recurrence in 1.1 %, junction stump or neovasculature without clinically relevant recurrence in 1.6 % of cases. In summation, the total amount of actual recurrences was 4.8 %.

Research paper thumbnail of Die Chirurgie der Vena saphena parva – endoluminal oder operativ

Research paper thumbnail of Crossectomy (flush ligation) of small saphenous vein

Phlebologie, 2020

A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom car... more A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom carried out in literature. The two authors thoroughly describe the technical procedure of a high, flush ligation of the saphenopopliteal junction (SPJ). The risks and problems of the surgery are described and illustrated. A retrospective cohort study with the aim of conducting a flat small saphenous crossectomy yielded the following findings in 187 operated legs: small saphenous remainder stumps with clinically relevant recurrence in 2.1 %, small saphenous neovasculature with clinically relevant recurrence in 1.1 %, junction stump or neovasculature without clinically relevant recurrence in 1.6 % of cases. In summation, the total amount of actual recurrences was 4.8 %.

Research paper thumbnail of Functional repair of the great saphenous vein by external valvuloplasty reduces the vein's diameter: 6-month results of a multicentre study

Journal of International Medical Research

Objectives External valvuloplasty (eVP) is a reconstructive surgical method to repair the functio... more Objectives External valvuloplasty (eVP) is a reconstructive surgical method to repair the function of the terminal and preterminal valves. We evaluated the 6-month outcomes of eVP regarding the diameter of the great saphenous vein (GSV). Methods Patients from five vein centres were included in this observational study. Follow-up involved detailed duplex sonography of the GSV. The venous clinical severity score (VCSS) and the C class of the clinical, aetiologic, anatomic and pathophysiologic (CEAP) classification were recorded. Results We enrolled 210 patients, with a follow-up rate of 58%; eVP was sufficient in 95.24% of the patients. The GSV diameters decreased significantly from 4.4 mm (standard deviation (SD): 1.39) to 3.9 (SD: 1.12), 4 cm distal to the saphenofemoral junction (SFJ); from 3.7 mm (SD: 1.10) to 3.5 mm (SD: 1.02) at the mid-thigh; from 3.6 mm (SD: 1.14) to 3.3 mm (SD: 0.94) at the knee and from 3.1 mm (SD: 0.99) to 2.9 mm (SD: 0.78) at the mid-calf. VCSS decreased s...

Research paper thumbnail of External valvuloplasty of the saphenofemoral junction in insufficient great saphenous veins – six weeks results of a prospective multicentre trial

Vasa

Summary: Background: Varicosis of the great saphenous vein (GSV) is a common disease. Most of the... more Summary: Background: Varicosis of the great saphenous vein (GSV) is a common disease. Most of the therapeutic concepts attempt to remove or destroy the truncal vein. However, the absence of the GSV could be harmful for further treatments of artherosclerotic disease as the GSV is often used as bypass graft in lower extremity or coronary artery revascularisations. External valvuloplasty (EV) is one of the vein-sparing treatment options. The aim of this clinical study was to describe the outcome, safety and complications of this procedure in a prospective multicentre trial. Patients and methods: The function of the terminal and preterminal valve was restored by external valvuloplasty. Furthermore, multiple phlebectomies of tributaries were performed. Patients were reinvestigated six weeks after surgery. Primary endpoint was the function of the external valvuloplasty measured by diameter of the GSV and the prevalence of reflux in the GSV. The eligibility of the vein as a potential bypas...

Research paper thumbnail of Key Abstracts

Research paper thumbnail of Medizinischer Kompressionsstrumpf (MKS)

Research paper thumbnail of Medical compression stocking (MCS)

Research paper thumbnail of Residual Stumps Associated with Inguinal Varicose Vein Recurrences: A Multicenter Study

European Journal of Vascular and Endovascular Surgery, 2008

m-CPI and CPI ROC curve analyses showed areas under the curves (AUCs) of 0.68 (95% confidence int... more m-CPI and CPI ROC curve analyses showed areas under the curves (AUCs) of 0.68 (95% confidence interval (CI), 0.48-0.87; p ϭ 0.046), 0.66 (95% CI, 0.51-0.81; p ϭ 0.067), 0.63 (95% CI, 0.45-0.81; p ϭ 0.148) and 0.65 (95% CI, 0.49 -0.80; p ϭ 0.101) respectively. Corresponding AUCs for prediction of morbidity were 0.64 (95% CI, 0.51-0.76; p ϭ 0.511), 0.62 (95% CI, 0.51-0.74; p ϭ 0.505), 0.54 (95% CI, 0.41-0.67; p ϭ 0.416) and 0.55 (95% CI, 0.42-0.68; p ϭ 0.451).

Research paper thumbnail of Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein

Journal of Vascular Surgery, 2006

Objective: To identify patient and physician-controlled treatment variables that might predict th... more Objective: To identify patient and physician-controlled treatment variables that might predict the persistence or redevelopment of saphenofemoral junction (SFJ) reflux. Methods: Thirteen European centers, with substantial lower extremity venous disease practices, examined their experience with SFJ ligation and GSV stripping for primary varicose veins in patients followed for >2 years, entering their data into a protocol-driven matrix that stipulated duplex Doppler imaging as an essential component of follow-up examinations and required a complete review of all peri-operative examinations, as well as all operative procedure and anesthesia notes. Matrix entries were centrally audited for consistency and credibility, and queried for correction or clarification before being accepted into the study database. Presence or absence of Doppler-detectable SFJ reflux was the dependent variable and principal outcome measure.

Research paper thumbnail of Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein

Journal of Vascular Surgery, 2006

Objective: To identify patient and physician-controlled treatment variables that might predict th... more Objective: To identify patient and physician-controlled treatment variables that might predict the persistence or redevelopment of saphenofemoral junction (SFJ) reflux. Methods: Thirteen European centers, with substantial lower extremity venous disease practices, examined their experience with SFJ ligation and GSV stripping for primary varicose veins in patients followed for >2 years, entering their data into a protocol-driven matrix that stipulated duplex Doppler imaging as an essential component of follow-up examinations and required a complete review of all peri-operative examinations, as well as all operative procedure and anesthesia notes. Matrix entries were centrally audited for consistency and credibility, and queried for correction or clarification before being accepted into the study database. Presence or absence of Doppler-detectable SFJ reflux was the dependent variable and principal outcome measure. Results: Among 1,638 limbs, 315 (19.2%) had SFJ reflux. After adjustment for follow-up length and imputing for missing values, multivariable analysis identified seven significant predictors. Ultrasonic groin mapping (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.20 to 0.40) and <3-cm groin incisions at or immediately below the groin crease (OR, 0.50; 95% CI, 0.32 to 0.78) were both uniquely associated with diminished probability of follow-up SFJ reflux. Prior parity (OR, 2.69; 95% CI, 1.45 to 4.97), body mass index >29 kg/m 2 (OR, 1.65; 95% CI, 1.12 to 2.43), <3-cm suprainguinal incisions (OR, 3.71; 95% CI, 1.70 to 5.88), stripping to the ankle (OR, 2.43; 95% CI, 1.71 to 3.46), and interim pregnancy during follow-up (OR, 4.74; 95% CI, 2.47 to 9.12), were each independent predictors of a greater probability of having SFJ reflux. Conclusions: The findings suggest that ultrasound groin mapping, reticence for short suprainguinal or longer groin incisions and extended stripping, and counseling women about the effect of future pregnancy are prudent clinical choices, especially for obese or previously parous patients.

Research paper thumbnail of Offene Varizenchirurgie – wann ambulant, wann stationär?

Phlebologie, 2020

Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimm... more Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.

Research paper thumbnail of Crossectomy (flush ligation) of small saphenous vein Die Krossektomie der V. saphena parva

A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom car... more A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom carried out in literature. The two authors thoroughly describe the technical procedure of a high, flush ligation of the saphenopopliteal junction (SPJ). The risks and problems of the surgery are described and illustrated. A retrospective cohort study with the aim of conducting a flat small saphenous crossectomy yielded the following findings in 187 operated legs: small saphenous remainder stumps with clinically relevant recurrence in 2.1 %, small saphenous neovasculature with clinically relevant recurrence in 1.1 %, junction stump or neovasculature without clinically relevant recurrence in 1.6 % of cases. In summation, the total amount of actual recurrences was 4.8 %.

Research paper thumbnail of Die Chirurgie der Vena saphena parva – endoluminal oder operativ

Research paper thumbnail of Crossectomy (flush ligation) of small saphenous vein

Phlebologie, 2020

A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom car... more A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom carried out in literature. The two authors thoroughly describe the technical procedure of a high, flush ligation of the saphenopopliteal junction (SPJ). The risks and problems of the surgery are described and illustrated. A retrospective cohort study with the aim of conducting a flat small saphenous crossectomy yielded the following findings in 187 operated legs: small saphenous remainder stumps with clinically relevant recurrence in 2.1 %, small saphenous neovasculature with clinically relevant recurrence in 1.1 %, junction stump or neovasculature without clinically relevant recurrence in 1.6 % of cases. In summation, the total amount of actual recurrences was 4.8 %.

Research paper thumbnail of Functional repair of the great saphenous vein by external valvuloplasty reduces the vein's diameter: 6-month results of a multicentre study

Journal of International Medical Research

Objectives External valvuloplasty (eVP) is a reconstructive surgical method to repair the functio... more Objectives External valvuloplasty (eVP) is a reconstructive surgical method to repair the function of the terminal and preterminal valves. We evaluated the 6-month outcomes of eVP regarding the diameter of the great saphenous vein (GSV). Methods Patients from five vein centres were included in this observational study. Follow-up involved detailed duplex sonography of the GSV. The venous clinical severity score (VCSS) and the C class of the clinical, aetiologic, anatomic and pathophysiologic (CEAP) classification were recorded. Results We enrolled 210 patients, with a follow-up rate of 58%; eVP was sufficient in 95.24% of the patients. The GSV diameters decreased significantly from 4.4 mm (standard deviation (SD): 1.39) to 3.9 (SD: 1.12), 4 cm distal to the saphenofemoral junction (SFJ); from 3.7 mm (SD: 1.10) to 3.5 mm (SD: 1.02) at the mid-thigh; from 3.6 mm (SD: 1.14) to 3.3 mm (SD: 0.94) at the knee and from 3.1 mm (SD: 0.99) to 2.9 mm (SD: 0.78) at the mid-calf. VCSS decreased s...

Research paper thumbnail of External valvuloplasty of the saphenofemoral junction in insufficient great saphenous veins – six weeks results of a prospective multicentre trial

Vasa

Summary: Background: Varicosis of the great saphenous vein (GSV) is a common disease. Most of the... more Summary: Background: Varicosis of the great saphenous vein (GSV) is a common disease. Most of the therapeutic concepts attempt to remove or destroy the truncal vein. However, the absence of the GSV could be harmful for further treatments of artherosclerotic disease as the GSV is often used as bypass graft in lower extremity or coronary artery revascularisations. External valvuloplasty (EV) is one of the vein-sparing treatment options. The aim of this clinical study was to describe the outcome, safety and complications of this procedure in a prospective multicentre trial. Patients and methods: The function of the terminal and preterminal valve was restored by external valvuloplasty. Furthermore, multiple phlebectomies of tributaries were performed. Patients were reinvestigated six weeks after surgery. Primary endpoint was the function of the external valvuloplasty measured by diameter of the GSV and the prevalence of reflux in the GSV. The eligibility of the vein as a potential bypas...

Research paper thumbnail of Key Abstracts

Research paper thumbnail of Medizinischer Kompressionsstrumpf (MKS)

Research paper thumbnail of Medical compression stocking (MCS)

Research paper thumbnail of Residual Stumps Associated with Inguinal Varicose Vein Recurrences: A Multicenter Study

European Journal of Vascular and Endovascular Surgery, 2008

m-CPI and CPI ROC curve analyses showed areas under the curves (AUCs) of 0.68 (95% confidence int... more m-CPI and CPI ROC curve analyses showed areas under the curves (AUCs) of 0.68 (95% confidence interval (CI), 0.48-0.87; p ϭ 0.046), 0.66 (95% CI, 0.51-0.81; p ϭ 0.067), 0.63 (95% CI, 0.45-0.81; p ϭ 0.148) and 0.65 (95% CI, 0.49 -0.80; p ϭ 0.101) respectively. Corresponding AUCs for prediction of morbidity were 0.64 (95% CI, 0.51-0.76; p ϭ 0.511), 0.62 (95% CI, 0.51-0.74; p ϭ 0.505), 0.54 (95% CI, 0.41-0.67; p ϭ 0.416) and 0.55 (95% CI, 0.42-0.68; p ϭ 0.451).

Research paper thumbnail of Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein

Journal of Vascular Surgery, 2006

Objective: To identify patient and physician-controlled treatment variables that might predict th... more Objective: To identify patient and physician-controlled treatment variables that might predict the persistence or redevelopment of saphenofemoral junction (SFJ) reflux. Methods: Thirteen European centers, with substantial lower extremity venous disease practices, examined their experience with SFJ ligation and GSV stripping for primary varicose veins in patients followed for >2 years, entering their data into a protocol-driven matrix that stipulated duplex Doppler imaging as an essential component of follow-up examinations and required a complete review of all peri-operative examinations, as well as all operative procedure and anesthesia notes. Matrix entries were centrally audited for consistency and credibility, and queried for correction or clarification before being accepted into the study database. Presence or absence of Doppler-detectable SFJ reflux was the dependent variable and principal outcome measure.