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Vein Stripping

Vein stripping is the surgical removal of a diseased saphenous vein (the most common cause of varicose veins). Vein stripping procedures are painful, expensive, frequently ineffective, and have recently been replaced by modern endovenous techniques. Ancient Egyptian, Greek, and Roman physicians described varicose vein stripping operations, as well as the serious complications frequently associated with them. The Roman tyrant Caius Marius, who died in 86 B.C., underwent varicose vein surgery. After the treatment on one leg he declined treatment of the other leg saying, “I see the cure is not worth the pain.” In 1905 Dr. William Keller first described inversion stripping of the saphenous vein to treat varicose veins. This rather excruciating operation has changed little over the last 100 years. It requires hospitalization, general anesthesia, and a protracted convalescence. Postoperative pain and swelling is often severe and demands 2-3 weeks leave from work. Many patients who have undergone vein stripping feel just like Caius Marius did 2000 years ago.

Despite the rather severe morbidity, vein stripping fails to relieve the patients’ venous reflux 50-65% of the time. Varicose vein recurrence is quite common after stripping. Vein stripping has earned a bad reputation, and justifiably so. Fortunately, these operations are largely of historical interest only; and have been replaced by recently developed minimally-invasive procedures including the radiofrequency “closure” procedure and endovenous laser ablation. Vein stripping is now utilized only rarely when endovenous radiofrequency and laser techniques are impossible.

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