Assessment of causes and patterns of recurrent varicose veins after surgery

N Am J Med Sci. 2012 Jan;4(1):45-8. doi: 10.4103/1947-2714.92905.

Abstract

Background: Varicose vein surgery is characterized by high recurrence rate of 60% after 5 years of follow-up observation, and this is a disappointing finding, both for the patient and surgeon.

Aim: To identify the possible causes and patterns of recurrent varicose veins.

Materials and methods: 92 patients with recurrent varicose veins were enrolled in this study. Full detailed history, examination, and investigations were done.

Results: 30 patients had recurrence after saphenofemoral disconnection, 22 patients with recurrence after saphenofemoral disconnection and stripping below knee, 28 patients recurrence after saphenofemoral disconnection with stripping above knee and 12 patients recurrence after sapheno-popliteal disconnection with stripping. The double great saphenous veins, neovascularization and deep venous thrombosis before and after surgery were the most observed patterns of recurrence. The anatomical patterns of recurrence were more in leg then both leg and thigh pattern.

Conclusion: Saphenofemoral ligation with below knee stripping has the least frequency of recurrence, while Trendlenberg operation alone has the highest.

Keywords: Causes; Patterns; Recurrence; Varicose veins.