title: Endovenous laser ablation (EVLA) of great saphenous vein to abolish "paradoxical reflux" in the Giacomini vein: a short report.
abstract: BACKGROUND
  Reflux in the GSV due to sapheno-popliteal incompetence associated with ascending (paradoxical) reflux in the Giacomini vein is a rare but well described pattern of reflux. Treatment of this type of reflux is controversial and only surgical treatment has been described.
  
  
  METHODS
  We describe 2 patients in whom this type of reflux was successfully abolished following endovenous laser ablation (EVLA) of the GSV with the SPJ and Giacomini vein regaining competency.
  
  
  CONCLUSIONS
  Paradoxical reflux in the Giacomini vein and SPJ is secondary to GSV incompetence which exerts a syphon effect. EVLA of the refluxing segment of GSV interrupts this effect and prevents the paradoxical reflux at the SPJ.
authors.affiliation: The Leeds Vascular Institute, General Infirmary at Leeds, Leeds, UK. nadacumar@yahoo.co.uk
authors.forename: N S
authors.initials: NS
authors.lastname: Theivacumar
authors.forename: D
authors.initials: D
authors.lastname: Dellagrammaticas
authors.forename: A I D
authors.initials: AI
authors.lastname: Mavor
authors.forename: M J
authors.initials: MJ
authors.lastname: Gough
mesh_terms: D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D014689:Venous Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*