1. SURGICAL TREATMENT OF TRUNCAL VEINS Stephen F. Daugherty, MD, FACS, RVT, RPhS

2. SAPHENOUS VEIN STRIPPING DESCRIBED IN 1905-1907 BY: William Keller Charles Mayo Stephen Babcock Rose, Sidney S. Historical Development of Varicose Vein Surgery in Varicose Veins and Telangiectasias, ed. Bergan and Goldman, Quality Medical Publishing; 1993: pp123-147.

3. “…many believe that the operation (saphenous vein stripping) is probably obsolete.” Bergan, John J. in Rutherford’s Vascular Surgery, 6 th ed; 2005: p2258.

4. SURGICAL OPTIONS Open Excision Saphenous Vein Ligation Ankle-to-Groin Saphenous Stripping Segmental Saphenous Stripping All of the above often were combined with phlebectomy.

6. PROBLEMS WITH VEIN LIGATION FREQUENT EARLY FAILURE DUE TO COLLATERAL INCOMPETENT VEINS NEOVASCULARIZATION DUE TO GROIN DISSECTION

8. PROBLEMS WITH ANKLE-TO-GROIN STRIPPING SAPHENOUS NERVE INJURY STRIPPING CALF OFTEN IS UNNECESSARY INTRAOPERATIVE BLEEDING HEMATOMA CAUSING PAIN

9. Use slide 33 from AMP talk, showing saphenous nerve.

10. PROBLEMS WITH SMALL SAPHENOUS VEIN STRIPPING SURAL NERVE INJURY VARIABLE LOCATION OF TERMINATION OF SMALLL SAPHENOUS VEIN

11. Use slide 34 from AMP talk, sural nerve

12. IMPROVEMENTS IN SEGMENTAL SAPHENOUS VEIN STRIPPING STRIP KNEE-TO-GROIN ONLY ULTRASOUND IMAGING FOR PASSAGE OF STRIPPER AND HOOK RETRIEVAL OF LARGE TRIBUTARY VEINS FOR LIGATION AND DIVISION OESCH PERFORATE-INVAGINATE (PIN) STRIPPING DESCRIBED IN 1993. Goren, G., Yellin, AE, JVS 1994; 20:970-977.

19. WHEN TO CONSIDER OPEN SURGERY? LARGE, COMPLICATED VENOUS ANEURYSM NEAR THE SFJ HIGH LIGATION COMBINED WITH PIN STRIPPING ENDOVENOUS THERMAL ABLATION FOAM SCLEROTHERAPY VERY SUPERFICIAL LONG TRUNCAL VEIN