The oldest reference to the treatment of varicose veins goes back to Hippocrates (Kos, 460-377 BC) who counselled patients with venous ulcers to avoid a sedentary life style.
The Roman physician Cornelius Celsus (Alexandria, 3-64 AD) introduced hook phlebectomy around 45 AD. Claudius Galenus of Pergamon (129-199 AD) modified the Celsus technique. The Arab physician Al- Zahrawi (Cordoba, 931-1013 AD, also called Albucasis) described the removal of the long saphenous vein using interrupted sequential longitudinal incisions. In modern times, Friedrich Trendelenburg (Berlin, 1844-1924) described mid-thigh ligation of the varicose great saphenous vein for the first time, although this concept had been known since the 7th century.
His disciple Georg Clemens Perthes (1869-1927) recommended an incision in the groin followed by ligation of the sapheno-femoral junction. At the beginning of the twentieth century various techniques of vein stripping were developed. We owe the first publication in this field to William Keller (1) from Chicago who described an invaginating stripping technique in 1905.
In 1906 Charles Mayo communicated an alternative method using a ring at the head of the stripper. In 1907 Stephen Babcock contributed the now widespread technique of using a stripper with an olive at its tip. In the Sixties, hook phlebectomy was rediscovered and popularised by Robert Muller. Around the turn of the milennium, novel treatment modalities using endovascular delivery of radiofrequency or laser light energy were introduced. Although early results appear promising, their final role remains to be clarified.
ME 02/05