Residual Stumps Associated with Inguinal Varicose Vein Recurrences: A Multicenter Study

Abstract

In patients with symptomatic groin recurrences, a long residual sapheno-femoral stump was found in about two thirds of cases. The first clinical signs of varicose vein recurrence can be expected 7-8 years after the initial treatment at the earliest. Long term follow up is required reliably to asses the outcome of treatment for varicose veins.

Great saphenous varicose vein surgery without saphenofemoral junction disconnection

“…The overall varicose vein recurrence rate was 14·0 per cent. This result is competitive with any other modern technique2–4, 7–20, 36.…”

“…From the time of Homans1, the standard surgical treatment for great saphenous varicose veins has included disconnection of the saphenofemoral junction (SFJ)2–5. However, as observed since 1861, first by Langenbeck6, paradoxically this site is the most frequent site of recurrence after varicose vein surgery7–13. An effective treatment for varicose veins that does not include SFJ disconnection could eliminate the ‘Achilles’ heel' of varicose vein surgery.…”

Five-year follow-up of a randomized, controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia

“…[10][11][12][13] To diminish the prevalence of SFJ recurrence after endovenous ablation caused by incompetent accessory veins, avoiding residual GSV stump formation is recommended, analogous to open surgery. 14 In most cases, if present, the AASV drain in the GSV is close to the SFJ. 15 There is no consensus regarding the placement of the laser fiber tip (or RF catheter) toward the SFJ.…”

“…We will follow our patients for a total of 10 years because neovascularization after SFL/S can still occur even 7 to 10 years after the procedure. 14 Before the start of the study, we decided to investigate explicitly groin recurrence because high ligation was not performed during EVLA. We hypothesized that studying recurrence at other locations would yield equivalent results.…”

Surgical Excision of a Large Popliteal Varicosity in a Patient with Type 3 Von Willebrand Disease

“…Endovenous laser and radiofrequency ablation are the preferred treatment modalities compared to surgery, as there is reduced post op pain and hospital stay [7] and can also be used safely in patients with VonWillebrands disease. [8] Surgery is the preferred choice of treatment in cases of large bleeding varicosities.…”