[Plication of the sapheno-femoral junction]

Plication of the long saphena at the sapheno-femoral junction (SFJ) is an alternative to flush ligation and stripping. This technique abolishes reflux at the SFJ without altering the vein which may be used for arterial surgery or coronary grafting. The selection of the candidate for plication is done with ambulatory venous pressure measurements and duplex scanning which indicate and quantify the superficial incompetence. The plication of the SFJ reduces the calibre of the vein to 60-70% for a length of 1.5 cm allowing the valvular cusps to close when flow in the femoral vein is reversed. In this study we evaluated 20 limbs (in 20 patients) 6, 12 and 24 months after plication. Venous reflux was significantly reduced with improvement of signs and symptoms. In conclusion, SFJ plication seems to be an effective physiological alternative to flush ligation. However long term results (greater than 5 years) must be still evaluated.