Skip to main content
SpringerLink
Log in
Book cover

Chronic Venous Insufficiency pp 69–78Cite as

Surgery of the Saphenous Veins

  • Chapter

  • 253 Accesses

Abstract

The concept that advanced cutaneous changes of chronic venous insufficiency (CVI) are the result of prior deep venous thrombosis continues to inhibit care of limbs with these stigmata. This is true despite the fact that it is known that primary valvular incompetence, not just prior thrombosis, is an important cause of venous ulceration.1 Dysfunction of the superficial or perforating veins of the legs, alone or in combination, is frequently the only finding in leg ulceration.2 It is clear, in addition, that the venous leg ulcer occurs mainly from reflux and not usually from persistence of the original obstructive process.3

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Lees TA, Lambert D. Patterns of venous reflux in limbs with skin changes associated with chronic venous insufficiency. Br J Surg 1993; 80:725–8

    Article  PubMed  CAS  Google Scholar 

  2. Labropoulos N, Leon M, Nicolaides AN, Giannoukas AD, Volteas N, Chan P. Superficial venous insufficiency: correlation of anatomic extent of reflux with clinical symptoms and signs. J Vasc Surg 1994; 20:953–8

    Article  PubMed  CAS  Google Scholar 

  3. Raju S, Fredericks R. Venous obstruction: an analysis of 137 cases with hemodynamic, venographic, and clinical correlations. J Vasc Surg 1991; 14:305–13

    Article  PubMed  CAS  Google Scholar 

  4. Arnoldi CC. Venous pressure in patients with valvular incompetence of the veins of the lower limbs. Acta Chir Scand 1966; 132:427–40

    Google Scholar 

  5. Payne SPK, London NJM, Newland CI, Thrush AJ, Barrie WW, Bell PRF. Ambulatory venous pressure: correlation with skin condition and role in identifying surgically correctable disease. Eur J Vasc Endovasc Surg 1996; 11:195–200

    Article  PubMed  CAS  Google Scholar 

  6. Shari SK, Sarin S, Cheatle TR, Scurr JH, Coleridge-Smith PD. Venous ulcers and the superficial venous system. J Vasc Surg 1993; 17:487

    Google Scholar 

  7. Walsh JC, Bergan JJ, Beeman S, Comer TP. Femoral venous reflux abolished by greater saphenous vein stripping. Ann Vasc Surg 1994; 8:566–70

    Article  PubMed  CAS  Google Scholar 

  8. Walsh JC, Bergan JJ, Moulton SL, Beeman S. Proximal reflux adversely affects distal venous function. Vasc Surg 1996; 30:89–96

    Article  Google Scholar 

  9. Gottlob R, May R. Venous valves. Springer-Verlag, Vienna 1986: 150.

    Book  Google Scholar 

  10. Bergan II. Saphenous stripping and quality of outcome. Leading Article. Br J Surg 1996; 83:1025–7.

    Article  Google Scholar 

  11. Darke SG, Penfold C. Venous ulceration and saphenous ligation. Eur J Vasc Surg 1992; 6:4–9.

    Article  PubMed  CAS  Google Scholar 

  12. Gloviczki P, Bergan JJ, Menawat SS et al. Safety, feasibility, and early efficacy of subfascial endoscopic perforator surgery (SEPS): a preliminary report from the North American Registry. J Vasc Surg 1997; 25:94–106

    Article  PubMed  CAS  Google Scholar 

  13. Raju S, Fredericks R. Venous obstruction: an analysis of 137 cases with hemodynamic, venographic, and clinical correlations. J Vasc Surg 1991; 14:305–13

    Article  PubMed  CAS  Google Scholar 

  14. Raju S, Easterwood L, Fountain T, Fredericks RK, Neglen PN, Devidas M. Saphenectomy in the presence of chronic venous obstruction. Surgery 1998; 123:637–44

    Article  PubMed  CAS  Google Scholar 

  15. Lofgren KA, Ribisi AP, Myers TT. An evaluation of stripping versus ligation for varicose veins. Arch Surg 1958; 76:310–16

    Article  CAS  Google Scholar 

  16. Larson RH, Lofgren ED, Myers TT, Lofgren KA. Long-term results after vein surgery. Study of 1,000 cases after ten years. Mayo Clin Proc 1974; 49;114–17

    PubMed  CAS  Google Scholar 

  17. Woodyer AB, Reddy PJ, Dormandy JA. Should we strip the long saphenous vein? London, John Libbey & Co., 1986: 151–4

    Google Scholar 

  18. Sarin S, Scurr JH, Coleridge-Smith PD. Stripping of the long saphenous vein in the treatment of primary varicose veins. Br J Surg 1994; 81:1455–8

    Article  PubMed  CAS  Google Scholar 

  19. Rutgers PH, Kistlaar PJEHM. Randomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg 1994; 168:311–15

    Article  PubMed  CAS  Google Scholar 

  20. Jakobsen BH. The value of different forms of treatment for varicose veins. Br J Surg 1979; 66:182–4

    Article  PubMed  CAS  Google Scholar 

  21. Munn SR, Morton JB, MacBeth WAAG, McLeish AR. To strip or not to strip the long saphenous vein? A varicose veins trial. Br J Surg 1981; 68:426–8

    Article  PubMed  CAS  Google Scholar 

  22. Neglen P, Einarsson E, Eklof B. The functional long-term value of different types of treatment for saphenous vein incompetence. J Cardiovasc Surg (Torino) 1993; 34:295–301

    CAS  Google Scholar 

  23. Neglen P. Treatment of varicosities of saphenous origin: comparison of ligation, selective excision, and sclerotherapy. In: Bergan JJ, Goldman MP (eds). Varicose veins and telangiectasias: diagnosis and treatment. Quality Medical Publishing, Inc., St. Louis, 1993.

    Google Scholar 

  24. Hammarsten J, Pedersen P, Cederlund C-G, Campanello M. Long saphenous saving surgery for varicose veins: A long-term follow-up. Eur J Vasc Surg 1990; 4:361–4

    Article  PubMed  CAS  Google Scholar 

  25. Hammersten J, Campanello M, Pederson P. Long saphenous vein-saving surgery for varicose veins (letter/comment). Eur J Vasc Surg 1993; 7:763–4

    Article  Google Scholar 

  26. Darke SG. Fewer recurrences with stripping. (Letter). Eur J Vasc Surg 1993; 7:764

    Article  Google Scholar 

  27. Fligelston L, Carolan G, Pugh N, Minst P, Shandall A, Lane I. An assessment of the long saphenous vein for potential use as a vascular conduit after varicose vein surgery. J Vasc Surg 1993; 18:836–40

    Article  Google Scholar 

  28. McMullin GM, Coleridge Smith PD, Scurr JH. Objective assessment of high ligation without stripping the long saphenous vein. Br J Surg 1991; 78:1139–42

    Article  PubMed  CAS  Google Scholar 

  29. Fitridge RA, Fronek HS, Dilley RB, Bernstein EF, Benveniste GL. Assessment of reflux in the greater saphenous vein (GSV) two years following high ligation. Cardiovasc Surg 1995; 3:71

    Article  Google Scholar 

  30. Papadakis K, Christodoulou C, Christopoulos D et al. Number and anatomical distribution of incompetent thigh perforating veins. Br J Surg 1989; 76:581–4

    Article  PubMed  CAS  Google Scholar 

  31. Ruckley CV. A color atlas of surgical management of venous disease. Wolfe Medical Publications, Ltd, London,1988

    Google Scholar 

  32. Bergan JJ. Surgical management of primary and recurrent varicose veins. In: Gloviczki P, Yao JST (eds). Handbook of venous disorders. Chapman & Hall, London, 1996

    Google Scholar 

  33. Bergan JJ. Common anatomic patterns of varicose veins. In: Bergan JJ, Goldman MP (eds) Varicose veins and telangiectasias: diagnosis and management. Quality Medical Publishing, St Louis, 1993

    Google Scholar 

  34. Bergan JJ, Goldman MP, Weiss RA (eds). Varicose veins and telangiectasias: diagnosis and treatment, 2nd edn. Quality Medical Publishing, Inc., St. Louis, 1999

    Google Scholar 

  35. Oesch A. Pin stripping: a novel method of atraumatic stripping. Phlebology 1993; 8:171–3

    Google Scholar 

  36. Hobbs JT. Perioperative venography to ensure accurate saphenopopliteal ligation. Br Med J 1980; 2:1578

    Article  Google Scholar 

  37. Murray JD, Bergan JJ. Development of open-scope subfascial perforator vein surgery (SEPS): lessons learned from the first 67 cases. Ann Vasc Surg, in press

    Google Scholar 

  38. Glovickzi P, Bergan JJ, Rhodes JM, Canton LG, Harmsen S, Ilstrup D. Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial Endoscopic Perforator Surgery (NA-SEPS) Registry. J Vasc Surg 1999; 29:489–503

    Article  Google Scholar 

Download references

Authors
  1. John J. Bergan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeffrey L. Ballard
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Vascular Surgery, Loma Linda University Medical Center, 11175 Campus St, RM#21123, Loma Linda, California, CA, 92354, USA

    Jeffrey L. Ballard MD, FACS

  2. North Coast Surgeons, 9850 Genessee Avenue, Suite 560, La Jolla, California, CA, 92037, USA

    John J. Bergan MD FACS

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag London

About this chapter

Cite this chapter

Bergan, J.J., Ballard, J.L. (2000). Surgery of the Saphenous Veins. In: Ballard, J.L., Bergan, J.J. (eds) Chronic Venous Insufficiency. Springer, London. https://doi.org/10.1007/978-1-4471-0473-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0473-5_8

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1149-8

  • Online ISBN: 978-1-4471-0473-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation