Late complications after “classical” phlebectomy in the system of the small saphenous vein

Abstract

Previously, we have performed the retrospective analysis based on the results of surgical treatment of varicose veins of the lower limbs in the system of the small saphenous vein (SSV) at the premises of vascular surgery department of N.E. Savchenko City Clinical Hospital 4 (Minsk) for 2009–2014. In 13.9 % of patients who underwent “classical” phlebectomy SSV crossectomy was performed leaving a stump of 20–35 mm. 13.5 % of patients had SSV removed to popliteal line, but it extended to the hip as a proximal brunch or Giacomini vein with reflux at the latter. 23.6 % of patients had SSV removed to the middle third of the tibia; 8.1 % — to the upper third of the tibia. 40.9 % of patients had SSV removed completely. A clinical analysis is performed of two cases of complications after phlebectomy in the small saphenous vein system: a patient with thrombophlebitis of the SSV stump and thrombus floating in the popliteal vein, and a patient with arteriovenous fistula of the popliteal region. The symptoms, clinical picture, diagnostic methods, prevention of venous thromboembolism and chronic heart failure are described.