title: Randomised trial of flush saphenofemoral ligation for primary great saphenous varicose veins.
abstract: OBJECTIVE
  The aim of this study was to assess different techniques of saphenofemoral ligation in the treatment of primary varicose veins.
  
  
  METHODS
  One hundred and eighty-two patients (210 legs) with primary saphenofemoral junction incompetence were randomised to standard saphenofemoral ligation (transfixion with an absorbable suture) (SSL) or flush saphenofemoral ligation (oversewing with 4/0 polypropylene) (FSL). All legs underwent additional great saphenous vein stripping and multiple phlebectomies. Patients underwent assessment preoperatively, and at 6 weeks, 1 year and 2 years postoperatively with clinical examination, duplex imaging and completion of the Aberdeen Varicose Vein Symptom Severity Score (AVVSSS).
  
  
  RESULTS
  A total of 148 patients (172 legs) attended follow-up at 2 years postoperatively. Recurrent varicose veins were visible in 30 legs (33 per cent) in the SSL group and 26 legs (32 per cent) in the FSL group (P=0.90). Neovascularisation was present in 20 groins (22 per cent) in the SSL group and 15 groins (19 per cent) in the FSL group (P=0.57). Nine cases of neovascularisation in the SSL group and five in the FSL group directly resulted in clinical recurrence (P=0.37).
  
  
  CONCLUSIONS
  Flush ligation of the saphenofemoral junction confers no advantage over standard ligation with respect to clinical recurrence and neovascularisation.
  
  
  BACKGROUND
  ISRCTN20235689 (http://www.controlled-trials.com).
authors: Department of Vascular Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK. becsjazz@tiscali.co.uk
authors: R J
authors: RJ
authors: Winterborn
authors: C
authors: C
authors: Foy
authors: B P
authors: BP
authors: Heather
authors: J J
authors: JJ
authors: Earnshaw
mesh_terms: D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D011788:Quality of Life; D012008:Recurrence; D012501:Saphenous Vein / Q000601:surgery*; D016037:Single-Blind Method; D014463:Ultrasonography; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*