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July 1975

Surgeon, Spare That Saphena!

Author Affiliations

Portsmouth, Va

Arch Surg. 1975;110(7):848. doi:10.1001/archsurg.1975.01360130080026

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To the Editor.—The greater saphenous vein is the best choice for an autogenous replacement in femoropopliteal arterial reconstruction. Increasing use of the saphenous vein has multiplied its value, and should stimulate a more careful appraisal of surgical indications by the surgeon who proposes to remove it to treat symptoms in the lower extremity.

During past years, most surgeons will admit to having occasionally stripped the saphenous vein where the symptoms did not exactly match the clinical findings. Often the conditions of these patients were improved, and improvement was considered enough. It now seems appropriate to submit that such latitude may no longer be permissible.

As the greater saphenous vein assumes a higher value to its owner, so must the surgeon regard more carefully his inclination to operate for symptoms where physical signs are less than striking. Thus, he might reasonably ask himself the following questions:

  1. Is there clear

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