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Most Varicose Veins Can Be 'Cured'

For most patients with varicose veins, "cure" is possible, and major recurrence can be curbed by Doppler diagnosis and precise surgery despite new sites of incompetence appearing over time in some people.

D. D. I. Wright and colleagues from Surgicare Manchester, an independent provider of treatment, and the University of Manchester, Manchester, England, sought to determine site-specific rates of recurrence in 246 patients following a consecutive series of 250 varicose vein operations. This was done via a postal questionnaire followed by telephone enquiries.

For all patients with responses suggesting recurrence, full clinical review, including continuous wave and duplex Doppler investigations, was carried out.

Of the 246 patients who were treated, 208 (85 percent) could be contacted for follow-up. Mean time to re-examination was 27 months. Twelve patients returned spontaneously, and 51 were recalled for examination based on questionnaire responses.

Researchers divided recurrences into 'site,' 'perforator' or 'new site' recurrence.

Primary surgery to the sapheno-femoral junction (SFJ) had the lowest 'site' recurrence rate of 2.3 percent compared with 9.5 percent for SFJ re-operation.

Recurrence rates were higher for primary surgery (8.3 percent) and re-operation of the sapheno-popliteal junction (SPJ) (7.8 percent).

The researchers detected new incompetence in 5 percent of previously competent SFJ and two percent of previously competent SPJ.

Minor perforator incompetence was found in a further 14 percent.

All procedures in this study were guided by Doppler ultrasound and performed by surgeons working to the same protocol.
Phlebology Abstract Volume 16 Issue 3 (2002) pp 101-105. "Recurrence Following Varicose Vein Surgery"

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