A study on recurrent varicose veins
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 8, Issue 3
Abstract
Background and Objectives: Recurrent varicose veins occur in 40% of cases treated for primary varicose veins. The rate is variable as it depends on definition of recurrence, length of follow-up and the initial treatment. Approximately 20% of varicose vein surgery is for recurrent disease. Despite the long history and vast experience of varicose vein surgery, the exact cause of recurrence is still unknown. Inadequate primary intervention, neovascularisation are few of the proposed causes. Aim is to study the presentation and the pattern of recurrent varicose veins after intervention in the past. Methods: Patients with persistent or recurrent chronic venous insufficiency features after intervention in the past were subjected to venous Duplex scan of involved leg and the sites of incompetence identified. Results: Study showed maximum (14) number of patients between 41 to 50 Years at the time of presentation with recurrence. Mean age at presentation was 47.25 Years with a Standard deviation of 13.69 Years. 77.55% of the study population were male, mostly attributed to poor socio-economic class and cosmetic being less important concern among the population. 31% patient’s occupation involved either prolonged periods of standing still and 45% violent muscular efforts. 9 out of 49 patients had bilateral limb involvement. Pain and skin changes were the major complaints and skin changes were very common and were observed to be in advanced state. Out of 58 limbs (49 patients), 9 had undergone only perforator ligation and 2 had undergone sclerotherapy. Incompetent perforators was the most common finding (100%) on Duplex scanning. Other important sites of incompetence were; reformed GSV, collateral channels around previously ligated SFJ, new SSV/SPJ incompetence and deep venous reflux in decreasing order of frequency. Interpretation And conclusion: Pain and skin changes are the major presenting complaints and skin changes are very common and are observed in advanced state in cases of recurrent varicosities. Importance of knowledge of the pattern of recurrence is to differentiate several causes which dictate the therapeutic decisions. Patients with recurrent varicose veins have both a higher prevalence and a greater number of incompetent perforating veins than patients with primary varicose veins.
Authors and Affiliations
Nadeem Mohammed, Jithin Reji George, P S M Ameer ali
Keywords
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- DOI 10.26611/106834
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