Long-term Results of Great Saphenous Vein Ligation at the Saphenofemoral Junction and Above the Knee Combined with Trunk Foam Sclerotherapy

Abstract

The purpose of this study was to evaluate the long-term results of high ligation (Hi) combined with trunk foam sclerotherapy for the treatment of varicose veins associated with great saphenous vein (GSV) reflux. This study was a retrospective study. We compared the above-knee GSV occlusion rates and varicose veins recurrence rates (above CEAP classification clinical class 2) after surgery among the following four treatment groups: group H, Hi and partial resection of the GSV at the saphenofemoral junction (SFJ) and above the knee (AK) (181 legs); group HL, Hi and partial resection of the GSV at the SFJ and AK combined with trunk liquid sclerotherapy of the GSV (443 legs); groupHF, Hi and partial resection of the GSV at the SFJ and AK combined with trunk foam sclerotherapy of the GSV (490 legs); and groupST, Hi at the SFJ and stripping of the GSV (224 legs). Ten years after treatment, the above-knee GSV occlusion rate in group HF (67.4%) was higher than the rate of groups H (25.5%) and HL (20.1%) (p<0.01). The recurrence rate in group HF (33.1%) was lower than that in groups H (52.3%) and HL (57.5%) 10 years posttreatment (p<0.01). There was no significant difference in the recurrence at 10 years between Group HF (33.1%) and ST (35.1%). We conclude that high ligation and partial resection of GSV at the SFJ and AK combined with trunk foam sclerotherapy is a minimally invasive and effective method for treating varicose veins associated with GSV reflux and GSV diameter under 8 mm. Ten years posttreatment, this therapy resulted in a better GSV occlusion rate, with a recurrence rate similar to that after GSV stripping.