The Incidence, Diagnosis and Management of Sapheno-Popliteal Incompetence

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Abstract
The great variation in the reported incidence of S-P incompetence suggests that it is often overlooked in patients with varicose veins. In a small series of 200 patients the incidence of S-P incompetence was 24%. Recurrent varicose veins were due to primary S-P incompetence in 36% of legs (following S-F ligation) and recurrent S-P incompetence in 14%. The diagnosis is made on clinical and Doppler examination. Surgical management requires a sound knowledge of the anatomical and pathological variations in the popliteal fossa, and a wide exposure to ensure flush S-P ligation. Recurrent S-P incompetence is usually due to inefficient surgery, but may be due to ‘regrowth’ following flush S-P ligation.