[Sclerotherapy section of incompetent short saphenous veins: indications, technique, results]

Sclerotherapy section of the long consists of a combination of ligations, with section and injection of the proximal and distal segment of the long saphenous vein. This technique is performed under local anesthesia 10 centimeters from the saphenofemoral junction and can be performed as an outpatient procedure.

Inclusion criteria are incompetent long saphenous vein diameter over 9 millimeters in older patients whose Duplex-scan examination eliminated other leaking points such as anterior or posterior tributaries or the junction, reflux coming from superficial iliac circonflex veins or from vulvo-pudendal varicose veins. Our study concerned 75 patients. 78 limbs were operated, 72 were reviewed after 1 year and 65 after 3 years.

66 of the 72 limbs (91.6%) had an incompressibility without flux or reflux at the sapheno-femoral junction level after 1 year and 59 of the 65 limbs (90.8%) after 3 years. Sclerosis with incompressibility without flux or reflux was observed in the lower third of the thigh in 51 of the 72 limbs (70.8%) after 1 year and in 40 of the 65 limbs (61.5%) after 3 years, without any clinically detectable underlying varicose recurrence.

This technique is ambulatory and economic and ensures control of sapheno-femoral junction reflux. In the majority of reflux cases, the reflux observed in the lower third of the thigh is related to a Hunter perforanting vein that can feed an underlying varicose network. They were treated by ultrasound-guided ossifying injection.

The indications for this technique are incompetence of the sapheno-femoral junction in older patients with trophic disorders, allowing effective treatment of the source of the reflux with rapid healing of underlying trophic disorders.