Incomplete Removal of Great Saphenous Vein Is the most Common Cause for Recurrent Varicose Veins

Objective: Hie-tie and great saphenous vein (GSV) stripping decreases recurrence of varicose veins (VVs). However, varying lengths of residual-GSV are observed in patients with previous GSV stripping. This may explain high recurrence rates of VVs. The proportion of recurrent VV occurring secondary to suboptimal GSV stripping is calculated. Methods: Patients with recurrent VV (CEAP-class > C2) underwent venous duplex-ultrasound. Results: 419 limbs were investigated in 298 patients (189 women and 109 men); median age for women and men was 60 and 61 years, respectively; 32.2% had reflux in residual-GSV; 30.3% had groin-reflux; 20% had reflux in sapheno-popliteal confluence (SPC); 10.2% had primary segmental deep-venous incompetence (DVI), and 6.9% had reflux at multiple sites. The frequency of reflux in the residual-GSV was significantly greater than that of reflux in the SPC (P < .0001) and DVI (P < .0001) but not groin (P = .3652). Conclusion: Residual-GSV is an important cause for recurrent VV.