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1. How often do varicose veins recur?
Some people will develop new varicose veins in the years following an operation, but this is less common after thorough surgery. Currently, one in five patients sent to hospital with varicose veins has had vein surgery before. This proportion should decrease as more varicose vein surgery is done by specialists. Also, the risk of recurrent varicose veins may be reduced by the use of ultrasound scans (duplex) prior to surgery to delineate exactly which veins need to be removed in cases where this is not absolutely clear from the clinical examination alone.
2. Why do varicose veins recur?
There are several reasons why varicose veins may “come back” :-
· Veins may not have been tied off properly. If the junction between the superficial and deep veins is not tied off properly (in the groin or behind the knee), or if smaller branches (tributaries) are left untied in the groin, pressure can build up in the veins lower down the leg resulting in more varicose veins.
· Some veins may not actually have been removed. This is why it is important for the surgeon and patient to agree exactly which veins will be removed when the veins are being marked up by the surgeon immediately prior to the operation. If the varicose veins were very extensive or if severe skin changes or leg ulcers were present, removal of every visible varicose vein is not possible.
· The long saphenous vein (running in the thigh) may not have been stripped properly. This may increase the chance of further veins developing.
· New veins may grow. This occasionally occurs in the groin even after thorough surgery.
· New varicose veins may develop in a completely different venous system. For example, if veins arising from the groin were previously tied off and stripped (long saphenous system), veins arising from behind the knee (short saphenous system) may subsequently become a problem and vice versa. Veins which connect the superficial and deep vein systems at sites other than the groin or behind the knee (perforating veins) may develop leaky valves and cause further varicose veins.
· It is possible for new varicose veins to develop as a result of a problem developing in the deep veins of the leg (deep vein thrombosis). It is important to exclude this possibility by ultrasound scan (duplex) particularly if further surgery is contemplated.
· Being overweight, standing for long periods at work and having children may all increase the risk of varicose veins recurring.
3. How can recurrent varicose veins be prevented?
There is no way of guaranteeing that veins do not recur following surgery. However, it is clear from the above that the risk can be reduced by thorough, accurate surgery performed by a specialist and based on the results of pre-operative ultrasound scan (duplex) where appropriate. Simple measures may help to prevent new veins such as regular exercise, maintaining normal weight and wearing support stockings if one’s job involves a lot of standing.
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RECURRENT VEINS |
