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September 1949


Author Affiliations

From the Department of Surgery, Northwestern University Medical School.

Arch Surg. 1949;59(3):578-587. doi:10.1001/archsurg.1949.01240040586021

THOSE varicose veins of the lower extremities which properly lend themselves to surgical correction arise largely as a result of intravenous valvular incompetency. Such relative or absolute incompetency occurs either entirely in the superficial vein or primarily in the deep and secondarily in the superficial vein. Owing to the force of gravity this anatomic defect leads to a venous reflux in the unsupported superficial veins with production of the well known stasis effects in the distal portions of the lower extremity.

Since the establishment of the concept of valvular insufficiency as a cause of varicose veins, it has been the custom to consider the phenomenon of venous reflux largely in reference to the saphenofemoral junction at the fossa ovalis. This view is due in part to the early teachings of Homans,1 who pointed out the existence of the common and supposedly primary pathologic venous reflux at that point. With

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