Recurrent residual or progressive varicose veins: postoperative long term follow-up of 353 patients

This study aimed to evaluate the postoperative incidence of recurrent varicose veins (vv) and the possibility to differentiate the different types of recurrence.

Patients who underwent surgery for saphenofemoral junction (SFJ) incompetence, great saphenous vein (GSV) varicosity and at least one perforator incompetence and varicosity of tributaries between January 1998 and December 2003 were selected for the study. Surgery consisted in SFJ flush ligation, GSV stripping, perforator vein ligature, and phlebectomies. Patients were assessed by detailed interview, clinical examination, and color duplex imaging after 10 years. The differentiation in recurrent, residual and progressive vv was done by comparison of the pre-and intraoperative and the phlebographic documentation in particular with the findings on follow-up..

353 patients (400 legs) were analyzed at 120 ± 21 months. At follow up the vv were classified as recurrent in 23,75%, residual in 23,25%, and progressive in 21% of cases. Nine patients (1.9%) were reoperated after 70 ± 33 months, and 17 (3.5%) underwent sclerotherapy during follow-up.

Recurrent, residual, and progressive vv can be clearly differentiated with the presented methodology. The authors suggest a revised definition (NEVVAS- new vv after surgery) because the term recurrent and the known acronyms do not embrace exactly the three types of vv after surgery. Since residual and many recurrent vv are due to avoidable technical or tactical errors, it is important to classify them properly in order to avoid these complications.

Neovarices, NEVVAS (New Varicose Veins After Surgery), Neovascularization, Recurrent varicose veins, Residual varicose veins, Progressive varicose veins.