ABSTRACT
This chapter discusses options for surgery directed to superficial tributaries, saphenous veins and perforating veins. Ablation Selective des Varices sous Anesthesie Locale or French acronym for tributary varices phlebectomy under local anesthesiae, is a procedure favoured by some to remove varices but preserve the saphenous vein. A belief that high ligation alone preserves the vein for future use as an arterial bypass graft if occlusive arterial disease develops has been negated by the finding that long-term patency rates for arterial bypass grafting with a diseased vein are poor. Arterial disease coexisting with varicose disease takes priority for current management. Injury to the saphenous nerve or its branches can result from avulsion while stripping the adjacent vein particularly below knee or to division while avulsing varices. A polyester mesh is wrapped around the vein as a cuff and tightened, then fixed in position with prolene sutures.
