Long-term Results of Sclerotherapy Combined with High and Perforator Ligations (SHPL) without Sclerosing Thigh Long Saphenous Trunk

Abstract

Sclerosing thigh long saphenous trunk is routinely performed in SHPL. However, this maneuver is frequently associated with pigmentation, thrombosis, and cord-like induration in thigh, which patients complain after the treatment. To avoid these complications, we omit sclerosing thigh long saphenous trunk in performing SHPL for selected patients. Our empirical criteria for omitting this maneuver is varicosity less than 8mm diameter without reflux proximal to Dodd's perforator and skin lesion. To evaluate the adequacy of our criteria, 87 cases, 101 limbs after SHPL without sclerosing thigh long saphenous trunk from July 1998 to October 2003 were retrospectively reviewed. Disease free rates were 100%, 90.4%, and 70.7% at 1 year, 3year and 5year, respectively. Symptom free rates were 100%, 93.2%, and 77.2% at 1 year, 3year, and 5 year, respectively. These long-term results were similar to those reported after stripping surgery alone. Only one out of 23 recurrent cases had segmental recurrence associated with long saphenous trunk reflux. SHPL without sclerosing thigh long saphenous trunk is a less invasive and satisfactory treatment for patients selected by our criteria. For these patients, sclerosing thigh long saphenous trunk appears to have little influence on long-term outcome after varicose vein therapy.