Surgical Methods of Treatment of Varicose Vein Disease in the Small Saphenous Vein System. Modern State of the Problem

INTRODUCTION: Lower limb varicose vein disease holds the main position in the structure of chronic venous disorders and is the most common cause of the development of chronic venous insufficiency. In most cases, the varicose vein disease affects the system of the great saphenous vein, while the small saphenous vein is affected in no more than a quarter of cases. At the same time, it is this vein that creates certain difficulties in diagnostics and also gives a higher percentage of recurrences and postoperative complications. AIM: To analyze current literature data comparing the results of open, endovasal surgical techniques, as well as vein-preserving operations for varicose veins of the lower extremities. The article analyzes the results of open, endovascular surgical techniques, and of vein-preserving surgeries. CONCLUSION: Today, the treatment of patients with varicosis in the small saphenous vein system irrespective of the chosen technique of open phlebectomy or endovenous thermal obliteration is a compromise between a long stump and the risk of recurrence, and a short stump and the probability of complications. In this case, anatomical studies of the vessels of the saphenopopliteal junction zone with the exact arrangement of its tributaries would be most helpful. On the other hand, modern development of the ‘organ-preserving’ phlebectomy techniques creates the prospect for introducing physiologically beneficial techniques of ASVAL type. However, to substantiate these operations, further study of hemodynamic disorders is required.