We report an uncommon case of pulsatile varicose veins in a young woman caused by tricuspid valve insufficiency of rheumatic origin combined with an incompetent valve at the sapheno–femoral junction. She was treated with limited stripping of the great saphenous vein and local varicosities were excised. Postoperative recovery was complicated by a large haematoma in the thigh. Following our recent experience we believe that patients like this, with elevated venous pressure and requiring anticoagulant therapy for prosthetic valves, should be treated with sapheno–femoral dissociation alone.
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