Stripping of Great Saphenous Vein

Abstract

This literature review deals largely with the evolution of the views on the stripping of the great saphenous vein as a surgical procedure for the treatment of large varicose veins in the lower extremities. Various opinions, both positive and negative, as regards the advantages and disadvantages of this method for the open surgical intervention are discussed including its character and scope of applications with special reference to the effectiveness of elimination of pathological reflux on the one hand and the safety of this procedure on the other hand. The role of varicose vein stripping in modern phlebology is discussed taking into consideration the ever increasing contribution of endovasal technologies to the medical practice. The authors emphasize that the endovasal intervention could be the first-line treatment of the patients presenting with varicose veins. However, there are a number of clinical and technical limitations on the application of this method arising from the peculiar features of the anatomical structure of the main subcutaneous veins and related to the patient's condition at which open surgery should be preferred over the endovasal procedures. The main approach to the treatment of varicose veins still remains the open surgical intervention, the «short» stripping technique being the best treatment option for the majority of the patients suffering from varicose veins. The paper contains data extracted from the Russian-language and foreign literature publications concerning the choice of the optimal extent of the great saphenous vein stripping and the fate of the residual segment of the GSV trunk at the calf level after partial stripping.