VARICOSE-VEIN SURGERY WITH PRESERVATION OF THE SAPHENOUS-VEIN - A COMPARISON BETWEEN HIGH LIGATION AVULSION VERSUS SAPHENOFEMORAL BANDING VALVULOPLASTY AVULSION

Purpose: Surgical treatment of varicose veins with preservation of the greater saphenous vein (GSV) was studied. Methods: Patients with refl ux at the saphenofemoral junction and grossly normal GSV were treated with two different surgical techniques: perivalvular banding valvulopl asty (PVBV-A) of the saphenous valve, wherein the diameter of the uppe rmost saphenous valve was narrowed by Dacron-reinforced silicone band (12 patients, 15 extremities); and high ligation (HL-A) of the sapheno us vein, wherein the GSV was ligated flush with the femoral vein (14 p atients, 16 extremities). Both groups also had varicose tributaries of GSV avulsed through multiple stab incisions. Results: In the HL-A gro up two GSV (13%) remained completely patent, 10 GSV (62.5%) thrombosed partially, and the remaining four GSV (25%) had complete thrombosis. In the PVBV-A group 12 GSV (80%) remained completely patent and withou t refhux, one GSV (7%) remained patent but showing reflux. Two GSV (13 %) thrombosed completely. There were no surgical complications or recu rrences (mean follow-up was 9.4 months for PVBV-A and 9.5 months for H L-A), and the postoperative recovery time was similar for both groups. Conclusions: Both techniques are equally effective in the early elimi nation of varicosities. Preservation of the saphenous vein is signific antly better after PVBV-A (p < 0.01). A prospective randomized trial w ith long-term follow-up is required.