ABSTRACT
A patient with an incompetent saphenous vein may be asymptomatic from a clinical perspective. The incompetent saphenous vein may be an isolated finding or be associated with perforator and/or deep venous disease either of an occlusive or insufficient nature. The saphenous nerve lies in close proximity to the great saphenous vein the knee, and it is separate from it that location. There are certain conditions in which open surgery may be the preferred method of removing the pathologic saphenous vein, even though less invasive ablation techniques are available. The complete lack of a deep system capable of draining the lower leg of venous blood is a contraindication to saphenous vein removal. The initial indication that a pathologic saphenous system exists is based on patient symptoms. Saphenous high ligation and stripping of the vein has been the gold standard for the treatment of saphenous incompetence for over a century, with only minor modifications over the decades.
