Abstract
Saphenous reflux interferes with the physiological decrease in pressure and induces
ambulatory venous hypertension. Elimination of reflux is achieved by flush ligation
at the incompetent saphenofemoral junction and stripping of the great saphenous vein,
which is the basis of the conventional surgical therapy. Endovenous ablative methods
substitute stripping by thermal of chemical destruction of the saphenous trunk; they
usually refrain from saphenofemoral junction ligation. Short-term and medium-term
results up to 5 years, achieved after endovenous ablation without high ligation, are
comparable with those after conventional surgery, which questioned the necessity to
ligate the incompetent saphenofemoral junction. Nevertheless, clinical symptoms caused
by recurrent reflux occur as a rule not earlier than 8 to 10 years after efficient
abolition of reflux. Consequently, randomized studies with long-term follow-ups exceeding
10 years are necessary for trustworthy assessment whether it is justified to abstain
from saphenofemoral junction ligation.
Keywords
endovascular procedure - endovenous ablation - greater saphenous vein - lower extremity
- radiofrequency ablation - varicose veins - vein reflux
