COMBINED HIGH LIGATION AND STAB AVULSION FOR VARICOSE-VEINS IN AN OUTPATIENT SETTING

BACKGROUND. In recent years, the transition from radical surgery for t he treatment of primary varicose veins has been modified from the prev iously described high ligation with complete stripping of the greater or lesser saphenous vein. OBJECTIVE. The purpose of the herewithin-des cribed technique is to present a less invasive technique that incorpor ates saphenofemoral ligation with hook avulsion of branch varicosities . METHODS. Sapheno-femoral ligation with hook avulsion of branch varic osities is carried out tinder local anesthesia utilizing the tumescent technique with dissection, ligation, and division of the greater saph enous vein and its tributaries. The hook avulsion procedure removes re sidual diseased venous segments. RESULTS. Patients treated by this com bined ligation-hook avulsion approach achieve excellent functional and clinical results associated with a minimal side effect profile. CONCL USIONS. Combined flush sapheno-femoral ligation of normal saphenous ve ins (<8 mm in diameter) and hook avulsion of branch tributaries produc es excellent functional and cosmetic results with minimal morbidity. ( C) 1998 by the American Society for Dermatologic Surgery, Inc.