Surgical treatment of saphenous varices, with preservation of the main great saphenous trunk.

A review of the important steps required in the surgical procedure for treatment of varicose veins suggests a protocol in which all damaged veins are removed by the stab avulsion technique, only veins with incompetent proximal valves are ligated, and the long saphenous vein is never removed unless it is too damaged to use for arterial grafting. With this protocol of selective conservation it is possible to preserve valuable undamaged major leg veins and at the same time treat varicose veins efficiently. A 3-year postoperative review of 171 patients with 295 affected limbs treated in this way was done by independent observers. They found a recurrence rate of only 10.5%. There is evidence to suggest that Doppler testing for proximal valve competence will further improve results in the future.