Stab Avulsion of the Short Saphenous Vein Technique and Duplex Evaluation

Abstract

BACKGROUND: Stab avulsion, largely employed for removal of superficial collateral varicosities, is generally considered unsuited for surgical removal of the varicose short saphenous vein. OBJECTIVE: To describe the technique of stab avulsion of the short saphenous vein and objectively validate it by demonstrating the exact site of short saphenous vein division in the popliteal fossa. METHODS: Postoperative duplex scan of popliteal fossa in 18 limbs, 3.5 months after stab avulsion of the short saphenous vein. RESULTS: No short saphenous vein stump in 4 limbs (22%). An average 1.7-cm (range 1 to 4 cm) stump in the remaining 14 limbs. CONCLUSIONS: High (not flush) ligation of the standard short saphenous vein, considered adequate by experts who practice traditional (open field) surgery, can also be achieved by stab avulsion without a large incision, and dissection in the popliteal fossa. The stab avulsion technique is therefore adequate for removal of the standard short saphenous vein. However, because of the short-term follow-up of this study, in which cases high ligation is as efficacious as flush ligation cannot be indicated.