Purpose: To assess the outcome of venous ligation combined with or without sclerotherapy for the treatment of great saphenous varicose veins using air plethysmography.

Patients and methods: A total of 33 limbs with great saphenous varicose veins were analyzed in this study. Limbs were divided into two groups: venous ligation only group (n=22) treated by high ligation of the great saphenous vein and ligation of incompetent perforating vein only and venous ligation combined with sclerotherapy group (n=11) treated by venous ligation followed by sclerotherapy using polidocanol for residual varicose veins one month after venous ligation. 9 limbs without venous disease were in the control group. Venous filling index (VFI, ml/sec), ejection fraction (EF, %) and residual volume fraction (RVF, %) were measured by air plethysmography before venous ligation, at one month after venous ligation and at a mean follow-up period of 5.0 months in the venous ligation only group and 6.6 months in the venous ligation combined with sclerotherapy group.

Results: In the venous ligation only group (L group), VFI was 9.8ml/sec before treatment, 2.8ml/sec at one month after venous ligation, and 3.9ml/sec after treatment, while the respective values for EF and RVF were 46% and 46%, 52% and 37%, and 50% and 37%. In the venous ligation combined with sclerotherapy group (S group), VFI was 8.7ml/sec before treatment, 3.0ml/sec at one month after venous ligation and 2.6ml/sec after treatment, the respective values for EF and RVF being 37% and 48%, 55% and 27%, and 46% and 37%. In the control group, VFI was 1.6ml/sec, the respective values for EF and RVF being 51% and 32%. VFI at one month after venous ligation and after treatment was significantly lower than that before treatment in the L group and S group (p<0.01), VFI in the L group after treatment was significantly higher than the control group, but there were no significant differences in VFI after treatment between the S group and the control group. RVF at one month venous ligation was significantly lower than that before treatment in the venous ligation combined with sclerotherapy group (p<0.05).

Conclusion: Venous reflux of limbs with great saphenous varicose veins was improved by high ligation of the great saphenous vein and ligation of incompetent perforating vein combined with or without sclerotherapy. Air plethysmography is useful to evaluate the venous reflux of limbs.