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  • Title: Randomised trial of flush saphenofemoral ligation for primary great saphenous varicose veins.
    Author: Winterborn RJ, Foy C, Heather BP, Earnshaw JJ.
    Journal: Eur J Vasc Endovasc Surg; 2008 Oct; 36(4):477-84. PubMed ID: 18718771.
    Abstract:
    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).
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