The lateral accessory saphenous vein - a common cause of recurrent varicose veins.
BACKGROUND
Varicose veins commonly recur after surgery and present a large burden to the NHS. The aim of this study was to demonstrate that the lateral accessory saphenous vein is the commonest cause of groin recurrence of varicose veins and we discuss a possible anatomical reason for this.


METHODS
The case notes of all patients presenting to two vascular surgeons with recurrent varicose veins over a 3-year period were studied. All limbs were assessed by duplex ultrasound scanning. These scans were reviewed to identify the site of recurrence. When recurrence occurred in the groin, the scans were further evaluated to identify the cause of groin recurrence.


RESULTS
A total of 216 limbs in 186 patients were evaluated over a 36-month period. Of these, 141 (65%) demonstrated a recurrence in the groin: 56 (26%) recurrences were due to either incompetent thigh or calf perforators and there were 19 (9%) cases of saphenopopliteal or short saphenous vein incompetence. Out of 141 groin recurrences, 61 (43%) were due to a persistent lateral accessory saphenous vein.


CONCLUSIONS
The lateral accessory saphenous vein is the commonest cause of recurrence in the groin of varicose veins. It should be looked for specifically during pre-operative assessment duplex scanning and at primary surgery. If identified at operation, we believe it should be either stripped or avulsed to reduce the risk of recurrence.
Garner
J P
JP
Department of Vascular Surgery, Frimley Park Hospital, Camberley, Surrey GU16 5UJ, UK. garners@dialstart.net
Heppell
P S J
PS
Leopold
P W
PW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007264:Inguinal Canal / Q000098:blood supply; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D055502:Secondary Prevention; D018608:Ultrasonography, Doppler / Q000379:methods; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*