Anatomical patterns of the above knee great saphenous vein and its tributaries: implications for endovenous treatment strategy.

Objective : The aim of the present study was to analyse the anatomical patterns of the above knee great saphe - nous vein (GSV) and its tributaries in limbs with varicose veins in view of potential suitability for endovenous treatment. Methods : Limbs of a consecutive series of new patients with varicose veins presenting at the phlebologic clinic during a 4 month period were studied. In 73 limbs of 56 patients with varicose veins and both saphenofemoral junction and GSV reflux, anatomical patterns of the above knee GSV were defined as : - 'complete' GSV : main trunk visualised within the saphenous compartment from the groin to the knee - 'incomplete' GSV : main trunk partially visualised from the groin to mid thigh with a non-refluxing mostly hypo - plastic distal GSV and a superficial tributary vein (STV) parallel to the GSV. Results : 51 limbs (70 %) had a 'complete' GSV. In 4 of these 51 limbs reflux passed from the main GSV trunk to a STV at mid thigh level leaving a non-refluxing part of the GSV from mid thigh to the knee. Conclusion : In only 64% of limbs with varicose veins the entire above knee GSV was involved in the disease. This may have implications for endovenous treatment strategy.