Perforation-invagination (PIN) stripping of the long saphenous vein reduces thigh haematoma formation in varicose vein surgery

Objective: To compare the extent of thigh haematoma formation after perfora tion-invagination (PIN) stripping with that occurring after standard plicat ion stripping of the long saphenous vein. Design: Prospective, within-case, randomised study with analysis on an inte ntion-to-treat basis. Setting: The radioisotope department of a university teaching hospital. Patients: Fourteen patients undergoing bilateral varicose vein surgery. Interventions: Red blood cell labelling in vivo with Tc-99(m). Preoperative imaging of the long saphenous vein using a gamma camera. Randomisation of one leg to PIN stripping and the other to standard stripping of the long sa phenous vein to the knee. Patients were reimaged 6 h postoperatively. Main outcome measures: The extent of thigh haematoma formation. Results: There was no significant difference with respect to the severity o f varicosities in the long saphenous vein in the thigh between the limbs as signed to each group (n = 11) on the preoperative images (T = 25, 0.5>p>0.1 , Wilcoxon signed rank test). Thigh haematoma in the limbs that had undergo ne PIN stripping of the long saphenous vein was significantly less than tha t in the limbs that had undergone standard stripping (T = 10, 0.05>p>0.01, Wilcoxon signed rank test). Conclusion: PIN stripping of the long saphenous vein results in significant ly decreased haematoma formation compared with standard stripping.