Causes and treatment of recurrent varices of the lower limbs

: Recurrence of varicose veins following surgery is a common, complex and costly problem in vascular surgery. The aims of our study were to determine the causes of recurrent varicose vein disease, to compare the preoperative duplex ultrasound findings with surgical findings, and to evaluate the efficacy of our surgical policy. We retrospectively studied 49 limbs operated on for recurrent varicose veins. All patients were monitored 6 weeks and 6 months after surgery and then underwent clinical examination in June 2005. Preoperative duplex ultrasound showed 100% specificity and 97% sensitivity. The patients were operated on for recurrence 152.2 +/- 95.5 months after the primary operation. The incidence of postoperative minor complications was 8.1% and of re-recurrence 10.2%. In 73.5% of patients during surgical re-exploration of the groin we found one or more tributaries of the great saphenous vein/common femoral vein, producing reflux. In 90.1% of cases we also treated incontinent perforator vessels. We recommend surgical re-exploration of the sapheno-femoral venous junction and thorough preoperative study of the perforator vessels in all patients with recurrent varicose veins.