Long-term comparison of external valvular stenting and stripping of varicose veins

Background: The recurrence rate following stripping of the long saphenous vein is unacceptable. Repair of the terminal valve of the long saphenous vein is a physiological alternative. The aim of the present study was to prospectively compare the long-term recurrence rates in patients having had reparative and ablative procedures at the same time. Methods: Patients were grouped first into those receiving high ligation and stripping of the long saphenous vein in one limb and valve repair on the contralateral side. The second group consisted of those patients who received short saphenous vein removal and valve repair of the ipsilateral long saphenous system. Finally, the effect of pregnancy on patients who received valve repairs was also studied. All patients were examined postoperatively clinically and with duplex ultrasound. Results: Cumulative and absolute recurrence rates for both procedures were analysed. Over the 13-year follow-up period, external valvular stenting produced a superior outcome. The effect of pregnancy on the venous valve repair cases resulted in recurrences in 23% of cases but there was no evidence of incompetence at the site of the valve repair. Conclusion: If a valve repair is possible at the saphenofemoral junction, then it should be the preferred treatment option.