Surgery for recurrent sapheno-femoral incompetence using expanded polytetrafluoroethylene patch interposition in front of the femoral vein: Long-term outcome in 119 extremities

Objective: To assess the long-term results of re-do surgery for recurrent varicose veins using polytetrafluoroethylene patch interposition to correct a recurrent varico-femoral junction (RVFJ). Methods: In 170 extremities (137 patients) with RVFJ greater than 3 mm in diameter, re-do surgery was done with patch interposition and without extensive resection of neovascularisation. Follow-up data based on physical and ultrasound examinations were obtained for 119 of these extremities (100 patients). Setting: Private-practice vascular surgery centre. Results: At follow-up (mean 4.9 years), 5 extremities (4.2%) had another RVFJ. In the 114 extremities with no RVFJ, 27.7% had no varicose veins or incompetent superficial veins, 45.3% had several small varicose veins without reflux, and 22.6% had diffused varicose veins and a new site of incompetence between the deep and superficial venous system. Conclusions: Re-do surgery using patch interposition lowers the long-term risk of another RVFJ. Wide resection of neovascularisation in the groin seems unnecessary.