Abstract
Objective: To present the results of external valvuloplasty of the saphenofemoral junction in selected patients with insufficiency of the greater saphenous vein after a mean follow up of 54 months.
Methods: A total of 54 legs were prospectively studied and re-examined a mean of 54 months after the operation. The severity of the patients' symptoms and their satisfaction with the procedure were recorded. Furthermore, the venous refill time, the severity of reflux and the diameter of the greater saphenous vein were recorded preoperatively and again at follow up.
Results: In 46 cases (85%) the patients were satisfied with the outcome of the procedure. At follow up, the mean severity of symptoms was significantly lower in every symptom category. The venous refill time was reduced by a mean of 5 seconds and the diameter of the greater saphenous vein was reduced by a mean of 3 mm. Reflux in the saphenofemoral junction despite the valvuloplasty was demonstrated in six legs (11.1%), and reflux in the distal saphenous trunk despite a competent valvuloplasty was seen in 18 cases (33.3%). When reflux was present at the follow-up examination, it affected a significantly shorter segment of the greater saphenous vein than preoperatively. Treatment for recurrent symptoms was necessary in 10 (18.5%) limbs.
Conclusions: External valvuloplasty of the saphenofemoral junction offers good results in terms of patient satisfaction, relief of symptoms and recurrence rate. With long-term results still pending, this vein-sparing operation might be an alternative to stripping in selected patients.