Surgery for recurrent varicose veins: toward a less-invasive approach?

Perspect Vasc Surg Endovasc Ther. 2011 Dec;23(4):244-9. doi: 10.1177/1531003511408338. Epub 2011 Aug 1.


Redo surgery for recurrent varicose veins, involving the saphenofemoral junction (SFJ) or saphenopopliteal junction has a bad reputation because it is a laborious, time-consuming intervention, characterized by a high incidence of postoperative complications. Moreover, outcome is worse than after primary surgery. This is illustrated by long-term (5 years) prospective follow-up of 235 reoperated limbs after redo procedure at the SFJ, all performed at the University Hospital of Antwerp between 1991 and 2009. Such invasive redo procedures will soon belong to the past because, nowadays, many less-invasive alternatives are available: phlebectomies without reopening the groin, focusing on the "varicose reservoir"; limited redo surgery with combined with foam sclerotherapy; endovenous ablation of a residual refluxing saphenous trunk; ultrasound-guided foam sclerotherapy; embolization treatment of pelvic vein incompetence; and treatment of an underlying deep-venous obstruction. All these interventions can be performed in an ambulatory setting, without need for general anesthesia.

MeSH terms

  • Ablation Techniques
  • Belgium
  • Follow-Up Studies
  • Humans
  • Minimally Invasive Surgical Procedures* / adverse effects
  • Patient Selection
  • Prospective Studies
  • Recurrence
  • Reoperation
  • Sclerotherapy
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / surgery*
  • Vascular Surgical Procedures* / adverse effects