Duplex-derived evidence of reflux after varicose vein surgery: neoreflux or neovascularisation?

Eur J Vasc Endovasc Surg. 1999 Mar;17(3):230-3. doi: 10.1053/ejvs.1998.0719.


Background: Recurrent varicose veins remain a problem in surgical practice despite improvements to the preoperative investigation of, and surgery for varicose veins. Neovascularisation accounts for some cases of recurrence within a few years of surgery, but other factors relating to disease progression must also play a part. We investigated whether new venous reflux (neoreflux) could occur in the early postoperative period (within 6 weeks) following successful varicose vein surgery.

Methods: Eighteen-month prospective observational study in the dedicated vascular surgery unit of a university teaching hospital. Forty-six patients, with primary saphenofemoral junction reflux, awaiting varicose vein surgery were chosen consecutively from the waiting list. All saphenofemoral surgery was performed in a standardised fashion. Assessments were performed prior to, at 6 weeks and at 1 year after surgery. Duplex ultrasound was used to identify and locate sites of reflux.

Results: Neoreflux was present at the 6-week postoperative scan in nine limbs after varicose vein surgery (19.6%), and resolved in 55.6% of patients within 1 year. Neovascularisation was noted in two limbs at the 1-year scan.

Conclusion: New sites of reflux, which may resolve spontaneously, occur in the early postoperative period despite adequate varicose vein surgery. It is our hypothesis that this is a manifestation of the effect of altered venous haemodynamics in a system of susceptible veins.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Leg / blood supply*
  • Leg / diagnostic imaging
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / diagnostic imaging*
  • Postoperative Period
  • Prospective Studies
  • Recurrence
  • Time Factors
  • Ultrasonography, Doppler, Duplex / instrumentation
  • Ultrasonography, Doppler, Duplex / methods
  • Ultrasonography, Doppler, Duplex / statistics & numerical data
  • Varicose Veins / diagnostic imaging*
  • Varicose Veins / surgery