Randomised trial of flush saphenofemoral ligation for primary great saphenous varicose veins

Eur J Vasc Endovasc Surg. 2008 Oct;36(4):477-84. doi: 10.1016/j.ejvs.2008.06.022. Epub 2008 Aug 20.


Objectives: The aim of this study was to assess different techniques of saphenofemoral ligation in the treatment of primary varicose veins.

Methods: One hundred and eighty-two patients (210 legs) with primary saphenofemoral junction incompetence were randomised to standard saphenofemoral ligation (transfixion with an absorbable suture) (SSL) or flush saphenofemoral ligation (oversewing with 4/0 polypropylene) (FSL). All legs underwent additional great saphenous vein stripping and multiple phlebectomies. Patients underwent assessment preoperatively, and at 6 weeks, 1 year and 2 years postoperatively with clinical examination, duplex imaging and completion of the Aberdeen Varicose Vein Symptom Severity Score (AVVSSS).

Results: A total of 148 patients (172 legs) attended follow-up at 2 years postoperatively. Recurrent varicose veins were visible in 30 legs (33 per cent) in the SSL group and 26 legs (32 per cent) in the FSL group (P=0.90). Neovascularisation was present in 20 groins (22 per cent) in the SSL group and 15 groins (19 per cent) in the FSL group (P=0.57). Nine cases of neovascularisation in the SSL group and five in the FSL group directly resulted in clinical recurrence (P=0.37).

Conclusions: Flush ligation of the saphenofemoral junction confers no advantage over standard ligation with respect to clinical recurrence and neovascularisation.

Registration number: ISRCTN20235689 (http://www.controlled-trials.com).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Female
  • Femoral Vein / surgery*
  • Humans
  • Ligation / methods
  • Male
  • Middle Aged
  • Neovascularization, Physiologic
  • Quality of Life
  • Recurrence
  • Saphenous Vein / surgery*
  • Single-Blind Method
  • Ultrasonography
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / surgery*

Associated data

  • ISRCTN/ISRCTN20235689