Cohort study reveals frequent saphenous neuralgia following infrainguinal arterial reconstruction, highlighting operative nerve trauma as the primary etiology.
Key Points
To determine the incidence, severity, clinical course, and etiology of saphenous neuralgia following vascular reconstructions below the inguinal ligament.
Assessed 55 patients undergoing infrainguinal revascularization via extended deep femoral angioplasty (EDFA, n = 28) or femoropopliteal bypass graft (FPBG, n = 27).
Monitored patients for the onset and severity of postoperative saphenous neuralgia across a mean follow-up of 18 months for EDFA and 33 months for FPBG.
Severe early postoperative saphenous neuralgia developed in 8 of 28 patients (28.6%) following EDFA and in 6 of 27 patients (22.2%) following FPBG.
An additional 10 EDFA patients developed mild early neuralgia and 3 developed late neuralgia, presentations not observed in the FPBG group.
Symptoms generally improved over time, leaving 23 patients (15 EDFA, 8 FPBG) with persistent mild neuralgia, with risk unaffected by age, sex, diabetes, or lumbar sympathectomy.