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


COD: 06_2017_09-2767 Categorie: ,

Juliana Anna Ebner, Anna Ebner, Maurizio Taurino, Stefan Morandell, Markus Falk, Carlo Stringari, Charalampos Dellis, Heinrich Ebner

Ann. Ital. Chir., 2017 88, 6: 526-533

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AIM: This study aimed to evaluate the postoperative incidence of recurrent varicose veins (vv) and the possibility to differentiate
the different types of recurrence.
MATERIAL OF STUDY: 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..
RESULTS: 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.
CONCLUSIONS: 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.