Results of long saphenous vein stripping

To audit retrospectively all long saphenous vein stripping performed or supervised intra-operatively by a single surgeon over a seven-year period.

One hundred and twenty-four patients (156 limbs) operated primarily in standard surgeon-supervised operations, were audited.

All patients were questioned via telephone interviews, and those with symptoms or recurrent varicosities were recalled for clinical review and investigations by the surgeon.

Eighty-seven cases presented with lower limb pain, 36 with eczema and 27 with ulcer. Eighty-one percent of operations were performed for symptomatic varicose veins and 19% were done for cosmesis. There were 153 limbs with varicosities, 121 of these had documented long saphenous vein reflux preoperatively. One hundred and sixteen limbs resolved post-operatively, five did not resolve, and four recurred. Incompetent perforators and short saphenous veins were the commonest causes of non-resolution and recurrence. Complications, including five cases of saphenous nerve paraesthesias, were temporary and met with full resolution eventually.

A 96% success rate is possible after high tie, stripping of the long saphenous vein with multiple avulsions of varicosities. Recurrence is 3% over the period of follow-up.