Page 69 - Virtual Vascular Vol 4

Surgery for Varicose Veins The SFJ is located in the groin crease, medial to the femoral pulse, and
approximately 2-3cm below to the pubic tubercle.

The wound is about 2cm long, and should be along the groin crease.
Indications for treatment of varicose veins:

- worsening symptoms with significant impact on quality of life

- complications of varicose veins such as eczema, skin changes with

hemosiderin pigmentation, lipodermatosclerosis, ulceration. Head end
- bleeding

- Superficial thrombophlebitis with thrombus very near to the

saphenofemoral junction (SFJ), in fear of progression to femoral vein Divided
deep vein thrombosis Saphenofemoral junction superficial

external
SFJ ligation, strip of great saphenous vein (GSV) , and multiple avulsions pudendal

of varicosities (Trendelenburg operation) remain the gold standard of Divided superficial vein

treatment for patients with incompetent SFJ and GSV. Other treatment circumflex iliac vein
options include radiofrequency ablation, laser ablation, or endovenous

cyanoacrylate injection. Lateral Medial

Anterolateral

vein of the thigh

Great (or long)
Usually, there are 5 venous tributaries which join the GSV

before the SFJ at the fossa ovalis. These 5 tributaries saphenous vein

should all be ligated individually and divided at surgery to
minimize the chance of recurrence.

Can you name these tributaries?

Foot end
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