Varicose vein surgery with preservation of the saphenous vein: a comparison between high ligation-avulsion versus saphenofemoral banding valvuloplasty-avulsion.
OBJECTIVE
Surgical treatment of varicose veins with preservation of the greater saphenous vein (GSV) was studied.


METHODS
Patients with reflux at the saphenofemoral junction and grossly normal GSV were treated with two different surgical techniques: perivalvular banding valvuloplasty (PVBV-A) of the saphenous valve, wherein the diameter of the uppermost saphenous valve was narrowed by Dacron-reinforced silicone band (12 patients, 15 extremities); and high ligation (HL-A) of the saphenous vein, wherein the GSV was ligated flush with the femoral vein (14 patients, 16 extremities). Both groups also had varicose tributaries of GSV avulsed through multiple stab incisions.


RESULTS
In the HL-A group two GSV (13%) remained completely patent, 10 GSV (62.5%) thrombosed partially, and the remaining four GSV (25%) had complete thrombosis. In the PVBV-A group 12 GSV (80%) remained completely patent and without reflux, one GSV (7%) remained patent but showing reflux. Two GSV (13%) thrombosed completely. There were no surgical complications or recurrences (mean follow-up was 9.4 months for PVBV-A and 9.5 months for HL-A), and the postoperative recovery time was similar for both groups.


CONCLUSIONS
Both techniques are equally effective in the early elimination of varicosities. Preservation of the saphenous vein is significantly better after PVBV-A (p < 0.01). A prospective randomized trial with long-term follow-up is required.
Schanzer
H
H
Mount Sinai School of Medicine, New York, NY.
Skladany
M
M
D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005268:Femoral Vein / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012501:Saphenous Vein / Q000503:physiopathology / Q000601:surgery*; D012828:Silicones; D013927:Thrombosis / Q000453:epidemiology / Q000503:physiopathology; D014648:Varicose Veins / Q000503:physiopathology / Q000601:surgery*; D014654:Vascular Patency
D011093:Polyethylene Terephthalates; D012828:Silicones