Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun;39(5):333-341.
doi: 10.1177/02683555231223063. Epub 2023 Dec 21.

The anterior saphenous vein. Part 4. Clinical and technical considerations in treatment. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology

Edward M Boyle  1 , Rachel Drgastin  1 , Nicos Labropoulos  2 , Alberto Caggiati  3 , Antonios Gasparis  2 , Suat Doganci  4 , Mark Meissner  5
Affiliations

The anterior saphenous vein. Part 4. Clinical and technical considerations in treatment. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology

Edward M Boyle et al. Phlebology. 2024 Jun.

Abstract

Background: The decision to treat a refluxing anterior saphenous vein (ASV) should be a clinical decision based on the assessment on the ASV's contribution to patient's signs and symptoms. Once the decision to treat has been made, there are anatomic, clinical, and technical considerations in treatment planning.

Methods: Clinical scenarios were discussed by a panel of experts and common anatomic, clinical, and technical considerations were identified.

Results: There are unique clinical considerations such as whether both the great saphenous vein (GSV) and ASV should be concomitantly treated, if a normal ASV should be treated when treating a refluxing GSV and when and how to treat the associated tributary varicose tributaries. Being aware of the anatomic, clinical, and technical considerations allows development of a treatment plan that optimizes long-term outcomes in patients with ASV reflux.

Conclusion: Ultimately the treatment plan should be tailored to address these types of variables in a patient-centered discussion.

Keywords: Anatomy; chronic venous insufficiency; radiofrequency ablation; recurrent varices; varicose veins.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: RD, EB, AC, SD, and MM reports no conflicts. NL is a Consultant/Speaker with Philips, Medtronic, BD Bard, and Boston Scientific; AG is a Consultant/Speaker: Medtronic, BD Bard, and Boston Scientific.

Figures

Figure 1.
Figure 1.
ASV and GSV reflux treated with a concomitant ablation and ultrasound-guided sclerotherapy of the branch tributary veins.
Figure 2.
Figure 2.
Isolated ASV reflux with normal GSV with varicose tributaries in the lateral thigh.
Figure 3.
Figure 3.
Dilated ASV in the thigh with proximal hypoplastic GSV in the thigh that dilates and refluxes at and below the knee.
Figure 4.
Figure 4.
GSV reflux treated in 2017 with normal ASV. ASV reflux in 2022 after prior GSV ablation in 2017.
Figure 5.
Figure 5.
ASV 21 mm from the superficial femoral artery (SFA).
Figure 6.
Figure 6.
Short length (4.06 cm) of intrafascial ASV that can be difficult to cannulate for RFA.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Garcia-Gimeno M, Rodriguez-Camarero S, Tagarro-Villalba S, et al. Duplex mapping of 2036 primary varicose veins. J Vasc Surg 2009; 49(3): 681–689. - PubMed
    1. Labropoulos N, Kang SS, Mansour MA, et al. Primary superficial vein reflux with competent saphenous trunk. Eur J Vasc Endovasc Surg 1999; 18(3): 201–206. - PubMed
    1. Bush RG, Bush P, Flanagan J, et al. Factors associated with recurrence of varicose veins after thermal ablation: results of the recurrent veins after thermal ablation study. Sci World J 2014; 2014: 505843. - PMC - PubMed
    1. Garner JP, Heppell PS, Leopold PW. The lateral accessory saphenous vein - a common cause of recurrent varicose veins. Ann R Coll Surg Engl 2003; 85(6): 389–392. - PMC - PubMed
    1. Svidersky Y, Goshchynsky V, Migenko B, et al. Anterior accessory great saphenous vein as a cause of postoperative recurrence of veins after radiofrequency ablation. J Med Life 2022; 15(4): 563–569. - PMC - PubMed