Late recurrent saphenofemoral junction reflux after ligation and stripping of the greater saphenous vein

Objective: This study was done to determine the long-term incidence of refluxing epifascial–to–deep vein reconnections in the area of the former saphenofemoral junction after ligation of the true junction, along with all proximal tributaries, and resection of the greater saphenous vein. Patients and Methods: A total of 125 limbs in 77 patients, representing 66% of 117 survivors among 602 patients who underwent operation between 1960 and 1967, were evaluated clinically and with duplex sonography for possible superficial–to–deep vein reconnections and clinical recurrence of thigh varicosities at a mean follow-up of 34 years. Results: Clinical examination suggested saphenofemoral recurrence in 59 limbs (47%). In 11 instances these were actually varices associated with isolated superficial system reflux or reflux originating from a distally located perforating vein. Color-coded duplex ultrasonography demonstrated saphenofemoral reflux in 75 limbs (60%), versus the 48 identified on clinical examination (P