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Eur J Vasc Endovasc Surg. 1999 Dec;18(6):494-8.

Reoperation for recurrent saphenofemoral incompetence: a prospective randomised trial using a reflected flap of pectineus fascia.

Author information

1
Department of Surgery, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, BH7 7DW, U.K.

Abstract

OBJECTIVE AND DESIGN:

in 1978 Sheppard described using a flap of pectineus fascia in an attempt to reduce the further development of neovascularised veins at the saphenofemoral junction. The perceived benefits of this manoeuvre have not been tested by a prospective randomised trial.

MATERIALS AND METHODS:

consecutive patients with symptomatic recurrent varicose veins referred to a single consultant were examined for evidence of further reflux from the saphenofemoral junction. This was subsequently confirmed in forty limbs (thirty-seven patients) by descending venography. All had features of a neovascularised segment. These patients were treated by complete exposure and ligation of the recurrences arising from the common femoral vein, with or without the placement of a flap of pectineus fascia (prospectively randomised). The patients were assessed a minimum of eighteen months later by both clinical examination and duplex ultrasound scanning.

RESULTS:

six patients were lost to follow-up. This left seventeen limbs remaining in each half of the study. The characteristics in each group were broadly matched.

CONCLUSIONS:

this study failed to demonstrate any apparent benefit from the application of a flap of pectineus fascia. Most patients showed evidence of re-recurrence arising from the common femoral vein.

PMID:
10637145
DOI:
10.1053/ejvs.1999.0906
[Indexed for MEDLINE]
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