[Crossectomy in the treatment of great saphenous vein insufficiency: a developing technique]

Crossectomy is an old and simple surgical technique for great saphenous vein insufficiency. At present the results in the international literature are not encouraging, possibly owing to a lack of standardized indications. The authors describe their experience. Crossectomy with phlebectomy of collaterals or perforating veins was performed (cross < 8 mm) in 132 patients. The mean follow-up was 21 months in 71 patients: subjective results (patient's opinion) were satisfactory to good in 81% for symptoms and in 77% for cosmetic results (disappearance of varicose veins). Objective results (surgeon's opinion) were less satisfactory: recurrent varicose veins were observed in 17 patients (23%: teleangectasias or truncal varices) and a residual saphenous reflux at color-coded doppler ultrasonography was still present in 43 patients. Postoperative saphenous reflux did not correlate closely with symptoms, suggesting that crossectomy may improve venous pump function even if reflux is not totally abolished. Crossectomy requires further investigation for evaluation of long term results; more accurate indications and preoperative screening may further improve the success rate of this simple technique.