How is vein ligation performed in the treatment of superficial venous insufficiency?

Updated: Sep 25, 2020
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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The original approach to vein ligation for superficial vein disorders involved removal of the entire GSV system; this approach has largely been supplanted by the stab evulsion technique. In stab evulsion, several 2- to 3-mm incisions are made overlying the GSV at various levels. The vein is dissected from the underlying tissues, and any perforators are ligated. A small hook or blunt needle is used to extract as much of the vein as possible.

Typically, stab evulsion is limited to areas above the knee in the GSV system to avoid damage to the saphenous nerve or sural nerve. This technique is reserved for CVI in which reflux in the saphenous system occurs and causes severe symptoms. For this reason, it is mandatory to establish a diagnosis of reflux preoperatively.

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