Operative and postoperative risks of combined interventions by phlebectomy and foam sclerotherapy: A retrospective analysis of the example of isolated anterior accessory vein incompetence

Background: Insufficiency of anterior accessory great saphenous vein (AASV) with a competent great saphenous vein (GSV) is frequently encountered in patients referred for phlebological evaluation. The classic therapeutic approach to treat AASV insufficiency consists of crossectomy and stripping of GSV and all tributaries. In isolated AASV insufficiency, stripping of the AASV combined with foam sclerotherapy of the proximal AASV section is a useful alternative to preserve the GSV. Historically, the combination of phlebectomy and sclerotherapy in a single session was avoided given the perceived and reported risk of complications Aim: A retrospective analysis of the side effects and complications following phlebectomy of the AASV combined with foam sclerotherapy in one session. Patients and method: Case records of all patients with isolated AASV insufficiency, who underwent a combined procedure (phlebectomy of the AASV and foam sclerotherapy) between 01.01.2013 and 30.11.2016, were evaluated. Results: 28 patients (29 legs) were included. There were no severe side effects or complications in any case. Complete occlusion of the proximal AASV could be demonstrated sonographically. Conclusion: The combination of phlebectomy and foam sclerotherapy in one session is an effective and safe treatment option in cases of isolated AASV insufficiency.