[Recurrence of varicosities in the femoral canal following surgery of the internal saphenous vein].
Perforating veins in the femoral canal, which establish a communication, on the medial aspect of the thigh, between the deep venous system and: either the trunk of the long saphenous vein, single or double, or one or several separate trunks, follow three anatomical patterns which clinical examination, phlebography and, now, echo-doppler, can identify clearly. When they are incompetent, they increase the natural progress of the varicose disease, after surgery of the long saphenous vein. Often, they are associated with a redux at the level of the saphenofemoral junction and also, sometimes, with an incompetence, primary or recurrent, at the short sapheno-popliteal junction, or, furthermore, with an incompetence of the medial gastrocnemial veins and their accompanying perforators, within the popliteal venous complex. Anastomotic networks between the different superficial venous territories in the inguino-genital region, the femoral canal and the supero-medial aspect of the leg, explain the cross-evolution between different systems. Sclerotherapy is effective when the perforators are not too large and their reflux not too important. If it fails, it is necessary to operate after precise localization of the sites of reflux through good imaging. A good picture is obtained with B mode ultrasound examination and hemodynamic studies with pulsed doppler and, even more reliably, with color Doppler. Thus, in recurrences in the femoral region, color Doppler will show up certain perforators which, despite being dilated, are nevertheless competent and do not need to be dealt with.
Rettori
R
R
CERM, Paris.
Franco
G
G
D005268:Femoral Vein / Q000601:surgery*; D006801:Humans; D010690:Phlebography; D011183:Postoperative Complications; D012008:Recurrence; D012501:Saphenous Vein / Q000601:surgery*; D015911:Sclerotherapy; D014648:Varicose Veins / Q000601:surgery* / Q000628:therapy