Neovascularization in Recurrence of Varices of the Great Saphenous Vein in the Groin: Phlebography

A method of improving radiologic definition in phlebography of recurrent varicose veins in the groin is described. Before injection of contrast material, venous return from the distal part of the limb was temporarily suspended by inflating a tourniquet surrounding the lower part of the thigh to a level higher than the systolic pressure. Toward the end of the injection procedure the patient performed a valsalva maneuver. Phlebography showed that the recurrent varices were more frequently in continuity with the great saphenous vein than collateral to it. Their tortuous or irregular outline did not usually correspond in position or appearance to normal tributaries of the vein. Radiographs of excised great saphenous vein injected with barium sulfate suspension showed that the valves of tributaries proximal to the site of surgical interruption of the vein remained competent. The findings provide further evidence of neovascularization in recurrence of varices of the great saphenous vein at the site of transection.