Eighty-nine patients with chronic venous insufficiency of the lower extremity underwent an extensive subfascial ligation of communicating veins. Eleven patients (13.4%) had an unsatisfactory result; the remainder improved. Contrary to belief by some, our patients who developed stasis phenomena and ulceration upon long-standing varicose veins did in fact have incompetent communicating veins. These patients for the most part had normal deep veins. Patients who developed stasis phenomena and ulceration subsequent to deep thrombophlebitis had incompetent communicating veins and also a high incidence of deep vein abnormalities. A high incidence of failure of operative treatment among patients with fibrous iliac and femoral vein occlusion made us regard this finding as a contraindication to surgical treatment.
Thurston OG, Williams HTG. Chronic Venous Insufficiency of the Lower ExtremityPathogenesis and Surgical Treatment. Arch Surg. 1973;106(4):537-539. doi:10.1001/archsurg.1973.01350160151025