[Saphenous vein-saving surgery--an alternative to stripping]

Area of Science:

• Vascular Surgery
• Phlebology
• Surgical Innovation

Context:

• Standard great saphenous vein stripping is a common treatment for varicose veins.
• Long-term outcomes and patient-reported morbidity of vein-saving techniques are areas of ongoing research.
• Varicose vein formation is linked to perforator vein incompetence.

Purpose:

• To evaluate the efficacy of a vein-saving surgical approach for varicose veins.
• To compare clinical and hemodynamic outcomes of vein-saving surgery versus standard stripping.
• To assess patient-reported postoperative discomfort.

Summary:

• A 12-year study explored vein-saving surgery, involving pre-operative mapping and occlusion of incompetent perforators, as an alternative to standard stripping.
• Four-year follow-up demonstrated comparable clinical and plethysmographic outcomes between vein-saving surgery and standard stripping.
• The long saphenous vein (LSV) was preserved, with patients reporting reduced postoperative discomfort.

Impact:

• Findings suggest perforator incompetence is an early factor in primary varicose vein development.
• Vein-saving surgery improves hemodynamic function by occluding incompetent perforators and restoring LSV function.
• This technique is a viable option for patients at risk for future arterial reconstruction or those wishing to avoid LSV ablation.