The physiologic basis for ligation of the great saphenous vein in the treatment of varicose veins

Abstract

1. 1. By a series of tests, we have demonstrated the physiologic effect of high ligation of the saphenous vein for the correction of varicosities: 1.1. (a) The rate of blood flow in the varicosities is slowed. 1.2. (b) The blood flow ceases entirely in the upper segment of the ligated vein. 1.3. (c) At the point of injection (just above the level of the knee) the blood current whirls slowly, the flow being both upward and downward. 1.4. (d) Below the knee the flow is again downward and the rate is much slower than before ligation of the vein. 2. 2. Other studies, by which we have shown that there is a rapid readjustment of the venous pressure in the varicosities, seem to indicate that pressure changes play no part in the beneficial results obtained by ligation of the saphenous vein. 3. 3. By the use of elastic bandages to control the downward flow of blood, the current can be completely stopped. An ideal set of circumstances is thus established for the production of rapid, firm thrombosis following the injection of a sclerosing substance. The method is applicable to cases in which the saphenous vein is not involved as well as to those in which high ligation is necessary. No claim to priority is made for this procedure.