Varicose vein recurrence and patient satisfaction 10-14 years following combined superficial and perforator vein surgery: a prospective case study

Abstract

Objective: To assess real long-term varicose vein recurrence and patient satisfaction following surgical intervention with combined subfascial endoscopic perforator surgery (SEPS) and superficial venous surgery.

Method: Prospective consecutive case study (C3-C4). Patients were included March 1993 to September 1998 and 83/104 legs of 80/100 patients were re-assessed 2008; 71 legs underwent duplex ultrasound scanning (DUS).

Results: The median follow up was 12 years (range 10-14). Twelve patients/legs had undergone additional vein surgery during follow-up. Incompetent lower leg perforators were noted in 18/71 limbs (25%). Following groin surgery 23/51 (45%) showed a duplex detected groin recurrence, neovascularization dominated 18/23. In legs where primary great saphenous vein (GSV) surgery had been performed, groin recurrence was found in 14/37 (38%). Previously unknown deep vein incompetence was detected in 14/71 legs (20%), six had axial reflux. The correlation between DUS-detected recurrence and remaining symptoms and cosmetic result was low. The overall satisfaction was high, 70/82 (85%). Patient satisfaction did not deteriorate over time (p < .557).

Conclusion: Despite a fair number of DUS-detected recurrences, the overall long-term result, from the patients' point of view was surprisingly favorable. Technically well performed open venous surgery seems to result in a durable long-term outcome.

Keywords: Long-term follow-up; Neovascularization; Patient satisfaction; Perforator surgery; Prospective study; Subfascial endoscopic perforator surgery (SEPS); Varicose vein recurrence; Varicose vein surgery.