Abstract
This study was conducted to determine the optimal treatment for minimizing the recurrence of varicose veins, and to assess the value of the combined treatment of high saphenous ligation and sclerotherapy. A combined total of 967 limbs in 660 patients with primary varicose veins were treated. The treatments comprised: sclerotherapy alone in 81 limbs, high saphenous ligation alone in 3 limbs, a combination of sclerotherapy and high sephenous ligation in 843 limbs, and a combination of sclerotherapy and ligation of incompetent perforating veins in 10 limbs. Recurrent varicose veins appeared from 3 months after the initial treatment in 61 (6.3%) limbs. Saphenous-type recurrence, being the presence of saphenofemoral incompetence (SFI) and/or saphenopopliteal incompetence (SPI), was found in 20 limbs, and further treatment was given. Segmental-type recurrence, being superficial varices without SFI or SPI, was found in 41 limbs, all of which were treated with further sclerotherapy alone. To minimize the recurrence rate of varicose veins, the presence or absence of SFI, SPI, and incompetent perforating veins must be confirmed prior to the initial treatment. It was concluded that the combination of high saphenous ligation and sclerotherapy is effective for patients with SFI and/or SPI, whereas sclerotherapy alone is better for patients without SFI or SPI.
Similar content being viewed by others
References
Doran FSA, White M (1975) A clinical trial designed to discover if the primary treatment of varicose veins should be by Fegan's method or by an operation. Br J Surg 62:72–76
Trempe J (1991) Long-term result of sclerotherapy and surgical treatment of the varicose short saphenous vein. J Dermatol Surg Oncol 17:597–600
Tremblay J, Lewis EW, Allen PT (1985) Selecting a treatment for primary varicose veins. Can Med Assoc J 133:20–25
Einarsson E, Eklof B, Neglen P (1993) Sclerotherapy or surgery as treatment for varicose veins; a prospective randomized study. Phlebology 8:22–26
Goldman MP (1995) Sclerotherapy. Treatment of varicose and telangiectatic leg veins. Mosby-Year Book St. Louis, pp 354–364
Goldman MP (1995) Sclerotherapy. Treatment of varicose and telangiectatic leg veins. Mosby-Year Book. St. Louis, pp 221–222
Hobbs JT (1974) Surgery and sclerotherapy in the treatment of varicose veins. Arch Surg 109:793–796
Bishop CCR, Fronek HS, Fronek A, Dilley RB, Bernstein EF (1991) Real-time color duplex scanning after sclerotherapy of the greater saphenous vein. J Vasc Surg 14:505–510
Jakobsen BH (1979) The value of different forms of treatment for varicose veins. Br J Surg 66:182–184
Neglen P, Einarsson E, Eklof B (1986) High tie with sclerotherapy for saphenous vein insufficiency. Phlebology 1:105–111
Sarin S, Scurr JH, Smith PDC (1992) Assessment of stripping the long saphenous vein in the treatment of primary varicose veins. Br J Surg 79:889–893
Royle JP (1986) Recurrent varicose veins. World J Surg 10:944–953
McMullin GM, Smith PDC, Scurr JH (1991) Objective assesement of high ligation without stripping the long saphenous vein. Br J Surg 78:1139–1142
Papadakis K, Christodoulou C, Christopoulos D, Hobbs J, Malouf GM, Grigg M, Irvine A, Nicolaides A (1989) Number and anatomical distribution of incompetent thigh perforating veins. Br J Surg 76:581–584
Darke SG (1992) The morphology of recurrent varicose veins. Eur J Vasc Surg 6:512–517
Starnes HF, Vallence R, Hamilton NH (1984) Recurrent varicose veins: a radiological approach to investigation. Clin Radiol 35:95–99
Mosquera DA, Manns RA, Duffield RGM (1995) Phlebography in the management of recurrent varicose veins. Phlebology 10:19–22
Mitchell DC, Darke SG (1987) The assessment of primary varicose veins by Doppler ultrasound—the role of sapheno-popliteal incompetence and short saphenous systems in calf varicosities. Eur J Vasc Surg 1:113–115
Bradbury AW, Stonebridge PA, Callam MJ, Walker AJ, Allen PL, Beggs I, Ruckley CV (1994) Recurrent varicose veins: assessent of the saphenofemoral junction. Br J Surg 81:373–375
Zhang GJ, Adachi I, Duan Z, Zhang Q, Guo R, Tang L, Gong C, He S (1996) The accuracy of color Doppler flow imaging for the detection of symptomatic deep venous thrombosis in Chinese patients. Jpn J Surg 26:683–687
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ishikawa, M., Morimoto, N., Sasajima, T. et al. Treatment of primary varicose veins: An assessment of the combination of high saphenous ligation and sclerotherapy. Surg Today 28, 732–735 (1998). https://doi.org/10.1007/BF02484620
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02484620