Crossotomy, crossectomy and peripheral recurrences after conservative procedures for varicose veins

Fixing the venous reflux from the Saphenous-Femoral Junction (SFJ) is a key point in the surgical treatment of varicose veins in the territory of the Great Saphenous Vein (GSV). In the context of conservative procedures, this goal can be achieved by disconnecting the SFJ either leaving the gravitational (cranial) SFJ tributaries connected to the distal GSV (crossotomy), or also disconnecting the gravitational (cranial) SFJ tributaries (crossectomy). In this retrospective analysis we investigated the role of the surgical gesture performed on the SFJ on the development of peripheral recurrences in 671 limbs showing varicose veins in the GSV territory undergone the CHIVA cure over the past 30 years and with a follow-up more than 3 years. We found that, contrary to the GSV drainage, the surgical gesture on the SFJ was not “per sé” a significant risk factor. Interestingly, we also found that crossotomy resulted in a significantly higher rate of peripheral recurrences only within “draining” GSVs, while within “non-draining” GSVs the surgical gesture on the SFJ did not significantly affect the development of peripheral recurrences.