Anatomical variation of the saphenofemoral junction: A prospective study in a population with primary superficial venous insufficiency

Introduction/Objectives: High recurrence rates of lower limb varicose veins after surgery are one of the biggest dilemmas in the current practice of a vascular surgeon. Inadequate primary varicose vein surgery may be the result of a failure to appreciate the anatomical variations at the saphenofemoral junction (SFJ). The aim of the present study was to describe the surgical anatomy of the SFJ in a population of patients with primary superficial varicose veins. Methods: Operative findings were recorded prospectively in a consecutive series of 189 surgical procedures (140 patients) during a 19 months period of time. All the operations were performed by the same vascular surgeon. Results: 75% patients were female. The number of tributaries at the SFJ varied from one to seven. In 29, 1% of the dissections postjunctional tributaries were identified and all of them joined the medial aspect of the Common Femoral Vein (CFV). Conclusion: The introduction of the new Endovenous therapies questioned the importance given to the anatomy of the SFJ and its tributaries; nevertheless a thorough understanding of its anatomical variations is still important in insuring that the junction is managed safely and adequately in patients with varicose veins.