Varicose veins. Do not do phlebography unnecessarily; preserve the great saphenous vein!

Phlebography should be performed only on special indications, chiefly for the diagnosis of thrombosis. A non-invasive method such as venous plethysmography is valuable in assessing deep venous insufficiency. Local exstirpation of varices and perforants and percutaneous paired sutures round superficial varices are recommended instead of stripping, as the saphenous vein may be needed for arterial reconstruction in risk groups, e.g. all male smokers. Peripheral arterial pulsations should always be checked to ascertain that the symptoms are not due to arteriosclerotic occlusion.