CROSSECTOMY FOR ASCENDING THROMBOPHLEBITI S OF THE SUPERFICIAL LEG VEINS

Ascending thrombophlebitis of the superficial leg reins is known to pr opagate into the deep leg veins and to embolize. In a prospective stud y we followed up 44 patients with sonographically diagnosed ascending thrombophlebitis into the deep veins (V. saphena magna n=40, V. saphen a parva n=4). In 15 of 44 cases (34%) thrombosis of the crossing veins was found intraoperatively and 6 of 44 crossings were filled with flo ating thrombi into the deep vein lumina (14%). Among complications of treatment (11,4%) recurrence of thrombi in the ligated superficial res idual vein stump was seen in 2 of 44 cases. One of these patients suff ered a symptomatic, non-fulminant pulmonary embolism. The other patien t developed a femoral vein thrombosis. 1 patient had an abscess and 1 a seroma of the groin. In 11% of all cases ascending thrombophlebitis diagnosed duplexsonographically was not verified intraoperatively. Alt hough crossectomy proved to be effective in preventing propagation of thrombi into the deep veins thromboembolism remains a complication of ascending thrombophlebitis.