During recent years, practically every report concerning the treatment of varicose veins has emphasized the importance of a proper high ligation of the long saphenous vein. This implies that the long saphenous vein is ligated flush with the femoral vein after all of its adjacent branches are ligated and divided. Unfortunately, in a significant number of cases, the dissection is not carried high enough. Unless the femoral vein is visualized, branches of the saphenous vein near the saphenofemoral junction may be overlooked, and it is these vessels that usually cause recurrent varicosities. The predominant venous insufficiency is usually at the saphenofemoral junction, but there may be incompetent valves in other communicating vessels of the thigh or leg or at the short saphenous vein-popliteal vein junction. The success of operation depends upon the ability of the surgeon to detect and eliminate all sites of valvular incompetence.
Many diagnostic tests have been
Nabatoff RA. SIMPLE PALPATION TO DETECT VALVULAR INCOMPETENCE IN PATIENTS WITH VARICOSE VEINS. JAMA. 1955;159(1):27–28. doi:10.1001/jama.1955.02960180029006c
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