Outcome following saphenopopliteal surgery: a prospective observational study

Area of Science:

• Vascular Surgery
• Medical Imaging
• Vascular Ultrasound

Background:

• High recurrence rates are a concern after small saphenous varicose vein surgery.
• Saphenopopliteal junction (SPJ) reflux is a common cause of recurrence.

Purpose of the Study:

• To evaluate the initial success rates of SPJ surgery using preoperative and postoperative duplex scanning.
• To assess the efficacy of duplex-guided marking for SPJ ligation.

Main Methods:

• Prospective study of patients with ultrasound-proven SPJ reflux.
• Preoperative duplex ultrasound for skin marking of the SPJ.
• Postoperative duplex ultrasound for quality assurance scanning.

Main Results:

• Successful SPJ ligation was achieved in 96.7% of 90 procedures.
• Complete abolition of reflux occurred in 56.7% of cases.
• Persistent reflux in the small saphenous vein (SSV) was noted in 32.2%; however, subsequent SPJ ligation with SSV stripping eliminated superficial venous reflux.

Conclusions:

• Preoperative duplex marking significantly increases the success rate of SPJ ligation.
• Treating residual SSV reflux concurrently with SPJ surgery is crucial for preventing recurrence.
• Patients undergoing SPJ surgery should have duplex marking and consideration for SSV treatment.