Varicosis of the accessorial lateral saphenous vein: evidence of recirculation shown by pre-operative phlebography.

BACKGROUND

The incidence of varicosis of the anterior side branch of the long saphenous vein clinically ranges about 8 to 10% of descending venous decompensation, originating at the level of the thigh. Its incidence in women showing significant overweight is clearly pronounced. Mostly torturous and enlarged varicosed segments of the accessorial lateral saphenous vein can be seen clinically crossing the anterior middle of the thigh. The indications for surgical radical extirpation of the entire varicosed side branch depends from pain, phlebitic complications, peripheral venous dysfunction including cosmetic aspects.

PATIENTS

In a clientele of 138 patients (females: 114, males: 24) the phlebographic demonstration of the entire recirculation pathways was performed prior to surgery.

RESULTS

Ascending leg phlebography was found sufficient in 7.7% of cases only. Combined with varicography however, in further 90.7% of patients a clear demonstration of the upper and lower points of venous insufficiency was possible. The extent of functional disorders was calculated by additional peripheral venous pressure measurements.

CONCLUSIONS

This clientele clearly shows that long-term reflux via the varicosed side branch increases the tendency of peripheral functional decompensation along the lower leg. Adequate surgical therapy depends from a clear demonstration of the varicosed veins being involved, and this can be realized by combined phlebography and varicography.