Can Interposition of a Silicone Implant After Sapheno-femoral Ligation Prevent Recurrent Varicose Veins?

Abstract

Interposition of a partition of silicone implant seems to lower the incidence of neovascularisation one year after saphenofemoral ligation. This technique may constitute an efficient method to prevent recurrence at the correctly ligated saphenous stump.

Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins

“…Clinically prominent veins were seen in six patients in group B as compared to only one patient in group A at 1 year of follow-up. Several other researchers have shown the efficacy of barrier techniques in reducing neovascularization [14,16,17].…”

“…Various authors have reported the efficacy of silicone patch interposition at SFJt in reducing neovascularization, but there is high incidence of deep vein thrombosis with the use of silicone implant [14,18]. Rij et al reported a highly significant decrease in n e o v a s c u l a r r e c u r r e n c e a t t h e S F J w h e n a polytetrafluoroethylene patch (PTFE patch, 3×3 cm) is interposed between the ligated vein stump and the overlying soft tissue.…”

“…Introduction of a physical barrier across the site of angiogenic focus will prevent new vessels crossing back and reconnecting the venous system. Various authors have claimed the effectiveness of barrier techniques in preventing neovascularization at SFJ [5,[14][15][16].…”

Surgical Treatment of Recurrent Varicosis

“…The recurrent vein can then be dissected and sutured with nonabsorbent material. Studies have shown that an additional barrier, separating the deep from the superficial vein system, may lower the rate of recurrent varicosis at the groin (De Maeseneer et al 2002;Van Rij et al 2008). This additional barrier could be made with a 2x3 cm patch, centrally secured over the area of the saphenofemoral junction and with its four corners to the deep vein's adventitia or onto the fascia.…”

Resecting the great saphenous stump with endothelial inversion decreases neither neovascularization nor thigh varicosity recurrence

“…The construction of an anatomic or prosthetic barrier, using a patch to cover the ligated saphenofemoral junction (SFJ), has been tested in primary varicose vein surgery with promising results. [14][15][16][17] Alternatively, technical modifications in the management of the SFJ itself have been proposed to reduce a putative stimulus from the exposed stump endothelium.…”