Early and late complications of silicone patch saphenoplasty at the saphenofemoral junction.
BACKGROUND
To reduce the incidence of postoperative recurrence after great saphenous vein (GSV) surgery, various barrier techniques have been introduced, aiming at containment of postoperative neovascularization at the saphenofemoral junction in the groin. Interposition of a prosthetic barrier (patch saphenoplasty) may be useful for this purpose; however, the incidence of postoperative complications after patch saphenoplasty is unknown. A prospective study examined the incidence of complications after patch saphenoplasty in primary and repeat varicose vein surgery.


METHODS
Silicone patch saphenoplasty was performed in a consecutive series of 462 limbs (primary GSV surgery in 380, repeat surgery in 82) in 387 patients. Early and late complications in the groin potentially related to patch saphenoplasty were registered at clinical follow-up after 1 week and at clinical and duplex ultrasound examination after 2 months, 1 year, and later in case of new symptoms.


RESULTS
Complications occurred in 44 limbs (9.5%), 28 (7.4%) after primary GSV surgery and 16 (19.5%) after repeat surgery (P < .01). After repeat surgery, half of the complications were lymphatic problems. Nine limbs (2.0%) developed a complication after >2 months. Wound infection was registered in 13 limbs (2.8%), lymphocele or lymphedema in the groin or thigh in 15 limbs (3.2%), symptomatic or asymptomatic proximal venous thromboembolism in 14 limbs (3.0%), and swelling of the thigh due to important stenosis of the common femoral vein visible on duplex scan in 4 limbs (0.9%). Two of the latter remained symptomatic even after venoplasty and stenting of the pinpoint stenosis of the common femoral vein.


CONCLUSIONS
Patch saphenoplasty can cause early and late postoperative complications in the groin, which are usually minor. In exceptional cases, major complications may cause important morbidity and may be difficult to handle.
De Maeseneer
Marianne G
MG
Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Edegem, Belgium. marianne.de.maeseneer@uza.be
Vandenbroeck
Chantal P
CP
Lauwers
Patrick R
PR
Hendriks
Jeroen M
JM
De Hert
Stefan G
SG
Van Schil
Paul E
PE
D001672:Biocompatible Materials / Q000009:adverse effects*; D015331:Cohort Studies; D003251:Constriction, Pathologic; D005260:Female; D005268:Femoral Vein / Q000473:pathology; D005500:Follow-Up Studies; D006119:Groin / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D008210:Lymphocele / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000517:prevention & control*; D010690:Phlebography; D011446:Prospective Studies; D012086:Reoperation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D055502:Secondary Prevention; D012828:Silicones / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology; D013923:Thromboembolism / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000601:surgery*; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D020246:Venous Thrombosis / Q000209:etiology
D001672:Biocompatible Materials; D012828:Silicones