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Recurrent Varicose Veins and causes

Residual and recurrent varicose veins are a common problem following varicose veins surgery to correct venous reflux and chronic venous disease. Identification of the causes and patterns of recurrence has been reported with the below breakdown showing the most common.

  1. New vascular regrowth – new blood vessels formation usually in the groin after inadequate surgical technique or overlooking tributary veins
  2. Incompetent perforating veins
  3. Missed or anew vein reflux
  4. Pelvic veins with venous reflux
  5. Inadequate previous operation
  6. Previously untreated veins

The accessory saphenous vein on the lateral thigh is the most common cause of recurrence of varicose veins in the groin. Research studies had also shown that other veins such as the anterior accessory saphenous vein on the anterior thigh were also involved.

These veins should be looked for carefully during assessment duplex scanning and at a surgery for definitive treatment.
Further research showed that recurrent varicose veins were also associated with incompetent perforating veins. Patients with recurrent varicose veins have both a higher prevalence and a greater number of incompetent perforating veins than patients with primary varicose veins.
In addition evidence suggests that leg varicose veins are associated with pelvic venous reflux , which is a major contributory cause of recurrent varicose veins in more than 25% of women. However, most venous facilities do not routinely look for pelvic venous reflux nor treat it adequately.
The frequency of recurrent varicose veins are believed to be between 20% to 80% depending on the definition of the recurrent varicose veins condition and the duration of follow up.
About 75% of recurrent varicose veins patients are symptomatic. Patients who seek treatment after their varicose veins surgery are likely to be older as a result of significant time elapsing before disease recurrence. The below-knee varicose veins recurrences have usually higher prevalence of venous reflux than above-the-knee which are associated associated with previously employed surgical techniques.

Modern Treatment for recurrent varicose veins

In the past, recurrent varicose veins were very difficult to treat with surgeons treating patients using general anesthesia and more invasive open surgical technique . Through skin incisions veins were stripped or tied with overall poor cosmetic outcome and longer recovery. With open surgical technique causing scars and veins to grow back from the lower down in the vein to the top of the vein (upside down problem), usually aimed at the wrong veins, it is not surprising that recurrent varicose veins are common. It is even less surprising that when open surgery for recurrent varicose veins is repeated, the results are even less successful.

Nowadays we are fortunate to offer our patients a wide range of minimal invasive procedures which can successfully treat difficult and complex varicose veins. Modern endovascular techniques are preferred method of treating any recurrent varicose veins. This allow us to treat any vein that can be seen with a duplex ultrasound scan, under local anaesthetic with the goal of achieving the best therapeutic outcome. Modern treatment for recurrent varicose veins include the following options:

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