Treatment of the Great Saphenous Vein by catheter based thermoablation is associated with Anterior Accessory Saphenous Vein treatment in almost a third of cases
M.S. Whiteley, X. Chen, L.E. Chase, J.M. Holdstock, C.C. Harrison, B.A. Price
The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey GU2 7RF
E-mail:  info@thewhiteleyclinic.co.uk
This work was presented as a poster at the ASGBI (The Association of Surgeons of Great Britain and Ireland) in Bournemouth, May 2008.
An abstract was published in British journal of Surgery 2008; 95(S3): 191-2
Reflux in the Anterior Accessory Saphenous Vein (ASSV), formerly “Lateral Thigh Vein”, is one of the commonest patterns of recurrent varicose veins. Catheter based thermo-ablation techniques (Endovenous Laser Ablation – EVLA or Radio-Frequency Ablation – RFA) require individual venous trunks to be cannulated and treated separately, increasing the time and complexity if an ASSV needs treating in addition to the great saphenous vein (GSV). The aim of this study was to see what proportion of our patients required treatment of the AASV whilst undergoing treatment of the GSV.
We performed a retrospective review of our local anaesthetic thermo-ablation cases over a two-year period.   Patients with a significant AASV on duplex ultrasonography were treated with thermo-ablation at the time of their GSV treatment.
In  the  two  years  studied,  1686  local  anaesthetic  vein  procedures  were  performed. Thermo-ablation of the GSV accounted for 479 (28.4%). Of these 341 (71%) required treatment of the GSV alone and 138 (29%) required treatment of the GSV and AASV.
The figures for primary procedures veins (307 GSV v 116 GSV + AASV) were not significantly different from recurrences (34 GSV v 22 GSV + ASSV p=0.07) but tended to be the more complex double treatment.
Using catheter thermo-ablation techniques, surgeons need to treat the AASV in almost a third of cases of GSV treatments. This will have implications on the time taken for these procedures.