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J Vasc Surg. 2004 Jul;40(1):98-105.

Silicone patch saphenoplasty to prevent repeat recurrence after surgery to treat recurrent saphenofemoral incompetence: long-term follow-up study.

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Department of Vascular Surgery, University Hospital Antwerp, Belgium.



Barrier techniques have been proposed to improve the results of repeat surgery to treat recurrent saphenofemoral junction incompetence. We hypothesized that interposition of a silicone implant would contain postoperative neovascularization and thus reduce the incidence of clinical recurrence at 5-year follow-up.


We compared the results of repeat interventions with use of silicone sheeting with a control group without artificial implants. The study was performed in hospitalized patients in a level 3 referral center (University Hospital). All patients underwent new flush ligation in the groin, with stab avulsion of recurrent varicosities. Two closure techniques were compared: in group A (33 limbs) the groin incision was closed in two layers; in group B (35 limbs) a piece of silicone sheeting was sutured on the saphenous stump. Clinical examination and duplex scanning were performed after 1 and 5 years postoperatively. Limbs operated on were checked in particular for the presence of recurrent thigh varicose veins. Color-coded duplex scanning was performed to assess for the presence of clinically relevant neovascularization, defined as the presence of a new vein with diameter at least 4 mm and with pathologic reflux in direct connection with incompetent varicose veins at thigh level.


Clinical examination after 1 year showed recurrent thigh varicosities in 24% of limbs in group A and 12% of limbs in group B (P =.369). After 5 years recurrent thigh varicosities were observed in 58% of limbs in group A and in 26% of limbs in group B (P =.009). Duplex scans after 1 year revealed neovascularization in 27% of limbs in group A and 6% of limbs in group B (P =.018). After 5 years neovascularization was present in 45% of limbs in group A and 9% of limbs in group B (P =.0007).


The use of a silicone patch at repeat operation to treat recurrent varicose veins caused by new incompetence at the level of the saphenofemoral junction is associated with a lower incidence of recurrent thigh varicosities and neovascularization compared with a control group in which no additional barrier technique was used.

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