Recent advances in the knowledge of varicose veins have emphasized the importance of three factors, namely, careful diagnosis, proper selection of cases and adequate therapeutic procedures. A systematized method of evaluating, selecting and treating the patients is therefore essential. At the University Hospitals the following concepts have proved valuable in relieving the greatest number of patients with varicose veins.
The usual anatomic positions of the venous components in the lower extremity are illustrated in the accompanying diagram.1 The deep veins are the anterior tibial, posterior tibial, peroneal, popliteal and femoral. The superficial veins are the long saphenous and the short saphenous with their many tributaries, including the accessory branches entering the saphenous fossa. The communicating veins connect the superficial and the deep veins. There are usually one to three communicating veins in the thigh and as many as fifteen to thirty in the leg.2 Blood normally