Original Articles Open access

Groin recurrences after surgical and endovascular treatments of varicose veins in the territory of the greater saphenous vein: a coherent hypothesis to explain their occurrence

Authors

Published
13 March 2025
Section
Original Articles
DOI
10.4081/vl.2025.13415

Abstract

Surgical and endovascular procedures to treat varicose veins in the territory of the Greater Saphenous Vein (GSV) are burdened by a variable rate of groin recurrences. In the case of surgical procedures, they are due to the development of tortuous vessels leading to the formation of a cavernoma in the site of the previous Saphenous-Femoral Junction, after crossectomy, or to a by-pass of the metallic clip, after crossotomy. In the case of endovascular procedures, groin recurrences are, instead, mainly represented by rectilinear vessels due to the progression of the incompetence within an antigravitational Sapheno-Femoral Junction (SFJ) tributary, most often the Anterior Saphenous Vein (ASV), and rarely by tortuous vessels leading to the formation of a cavernoma in the distal part of the stump always resulting from the procedure.

In this paper we suggest a coherent hypothesis to explain the occurrence of groin recurrences after surgical and endovascular procedures based upon experimental studies and observational data. Recurrences due to pelvic shunts or to incompetent thigh perforator veins, are not considered.

Keywords

References

  1. Ricci S. The saphenofemoral junction involvement in the treatment of varicose veins disease. Veins and Lymphatics 2017;6:65-73. DOI: https://doi.org/10.4081/vl.2017.6822
  2. Cappelli M, Molino-Lova R, Giangrandi I, et al. Ligation of the saphenofemoral junction tributaries as risk factor for groin recurrence. J Vasc Surg Venous Lymphat Disord 2018;6:224-9. DOI: https://doi.org/10.1016/j.jvsv.2017.09.005
  3. Crotty TP. The venous valve agger and plasma noradrenaline-mediated venodilator feedback. Phlebology 2007;22:116-30. DOI: https://doi.org/10.1258/026835507780807293
  4. Lee BB, Nicolaides AN, Myers K, et al. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence. International Angiology 2016;35:236-52.
  5. Van Cleef JF, Griton PH, Cloarec M, et al. Venous valves and tributary veins. Phlebology 1991;6:219-22. DOI: https://doi.org/10.1177/026835559100600403
  6. Belcaro G, Nicolaides AN, Laurora G, et al. Laser Doppler flux in the venous wall. Phlebology 1996;11:68-72. DOI: https://doi.org/10.1177/026835559601100208
  7. Tasch C, Brenner E. The ostial valve of the great saphenous vein. Phlebology 2012;27:179-83. DOI: https://doi.org/10.1258/phleb.2011.010096
  8. Curri SB. Le microangiopatie. Inverni della Beffa, Milano, Italy, 1986.
  9. Bottasso E. Toward the existence of a sympathetic neuroplasticity adaptive mechanism influencing the immune response. A hypothetical view—Part I. Frontiers in Endocrinology 2019;10:632. DOI: https://doi.org/10.3389/fendo.2019.00632
  10. Bottasso E. Toward the existence of a sympathetic neuroplasticity adaptive mechanism influencing the immune response. A hypothetical view—Part II. Frontiers in Endocrinology 2019;10:633. DOI: https://doi.org/10.3389/fendo.2019.00633
  11. Jänig W. Integrative action of the autonomic nervous system. Neurobiology of homeostasis. Cambridge University Press, Cambridge, UK, 2006. DOI: https://doi.org/10.1017/CBO9780511541667

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.

PlumX Metrics

License

Copyright (c) 2025 the Author(s)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.