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Break in Exhibit Hall & Posters in Foyer

Break in Exhibit Hall & Posters in Foyer

Saphenous Nerve Neuralgia as a Consequence of Varicose Veins Treatment

Tuesday, March 5, 2024
3:15 PM – 4:45 PM EST
Location: Foyer
Objective: Saphenous nerve neuralgia is an understudied complication observed in various surgical approaches aimed at treating varicose veins. Its occurrence is estimated to be approximately 15% to 30% across different techniques. Given its frequent appearance in vascular surgery, gaining a comprehensive understanding of the diverse techniques employed becomes paramount in identifying the safest approach to minimize nerve damage. A crucial aspect lies in comprehending the anatomy encompassing the saphenous nerve and recognizing the susceptible areas that may be affected during these procedures. This article aims to give a better understanding of saphenous nerve neuralgia as a complication in varicose veins treatment and to underly the safest surgical techniques. 

Methods:

We conducted a narrative review of 50 articles using electronic databases such as PubMed, Cochrane Library, Up to Date and Google Scholar, from 1980 to 2022. We researched techniques used to treat varicose veins and their relations with lesions in internal saphenous nerve and their symptoms. The following MeSH terms were used: “Venous insufficiency”, “Saphenous nerve neuralgia”, “Saphenectomy”, and “Side effects”. 25 articles meet the inclusion criteria and were included in the review. SANRA guidelines for narrative reviews were followed.  

Results: Among the 50 identified matching results, 26 papers were deemed eligible based on the inclusion criteria. Literature reports evidence regarding saphenous nerve injuries associated with various vascular procedures, including saphenectomy, stripping, thermochemical ablative therapy, sclerotherapy and endoscopic procedure. Notably, the utilization of ultrasound to locate and isolate the nerve before the procedure has shown potential for enhancing outcomes and reducing the occurrence of saphenous nerve neuralgia. Nevertheless, diagnosing the syndrome promptly can be challenging due to the wide range of symptoms it presents.  

Conclusions: Saphenous nerve injury remains a potential risk across various portions of the saphenous nerve, regardless of the specific technique employed during vascular procedures. Despite the clinical manifestation may be mil and the overall clinical significance may be minimal, it is important to acknowledge that internal saphenous neuralgia should be considered as a deterrent when considering conventional stripping, saphenectomy, ablation or endoscopic approaches. It is important to weigh the potential risk of nerve injury against the benefits and effectiveness of these procedures in treating varicose veins, as they continue to be viable options for many p</span>atients. Proper considerations can help minimize the likelihood of nerve damage and related complications.