Saphenous Neuralgia A Complication of Vascular Reconstructions Below the Inguinal Ligament

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Abstract
Although relatively frequent saphenous neuralgia (SN) is not usually reported as a complication of vascular operations below the inguinal ligament. In 55 patients undergoing extended deep femoral angioplasty (EDFA, n = 28) and femoropopliteal bypass graft (FPBG, n = 27) incidence and severity of postoperative SN were studied. Severe early postoperative SN was seen in 8/28 patients with EDFA and in 6/27 with FPBG. Milder SN was seen in 10 more patients with EDFA, and 3 others developed SN many months after surgery. The milder forms of SN and late SN were not encountered after FPBG. SN usually improved with time, and at last follow-up averaging 18 mo. for EDFA and 33 mo. for FPBG there were only 23 patients with mild SN (15 after EDFA and 8 after FPBG). The etiology of SN appears to be trauma to the nerve sustained during operation. Age, sex, diabetes or the addition of lumbar sympathectomy to the vascular operation did not affect the risk of sustaining early postoperative SN. Increased awareness of this complication may help explain its pathophysiology and possibly decrease its incidence.