Neovascularisation in the saphenofemoral junction after re-crossectomy with barrier implantation – A long-term follow-up

ObjectiveNeovascularisation in the region of the saphenofemoral junction after high ligation and stripping of the great saphenous vein is a well-known issue. Even after a re-crossectomy, new recurrences can occur. The aim of this study was to assess the occurrence of recurrent varicose veins after re-crossectomy with barrier implantation at the saphenofemoral junction.MethodsPatients who had undergone re-crossectomy with barrier implantation were examined in follow-up visits. During follow-up, detailed duplex sonographic examinations of the treated legs were performed, with a focus on the saphenofemoral junction.ResultsA total of 135 patients with 173 re-crossectomies and barrier implantations were examined. The interval between re-crossectomy with barrier implantation and follow-up examination was 11.06 years (±2.04 years). Dacron was used as the barrier material in 26 cases (15.0%), while PTFE was used in 147 cases (85.0%). Duplex sonographic examination detected neovascularisation in 109 legs (63.0%), with five cases (2.9%) having a diameter greater than 5 mm, which were classified as haemodynamically relevant.ConclusionNeovascularisation in the saphenofemoral junction after varicose vein surgery is common. The pathological mechanism of neovascularisation remains unclear. Further prospective randomised studies are necessary to assess the long-term success of re-crossectomy with barrier implantation.