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  • Title: [Echo Doppler classification of postoperative recurrence of varicose veins in the region of the internal saphenous vein].
    Author: Vin F, Chleir F.
    Journal: Presse Med; 1998 Jan 31; 27(4):148-52. PubMed ID: 9768020.
    Abstract:
    OBJECTIVES: Surgical treatment of varicose veins of the lower limbs is frequently complicated by recurrence. Although recurrence was long thought to result from technical errors, certain patients have progressive disease. METHODS: We used duplex-Doppler to assess 102 patients (160 limbs) with recurrence after resection of the saphene-femoral junction with stripping of the internal saphenous vein and the varicose network on the medial aspect of the leg. A vein map was established to classify recurrences. RESULTS: Type I, junctional stump with incontinent collateral, was observed in 22.5% of the cases. Type II, sapheno-femoral junction in an anatomic position, was found in 18.1%. Type III, backward flow from a perforating vein or a collateral of the common femoral was found in 13.1% and type IV, cavemomous aspect, in 7.5%. In 45% of the cases, the patient had a progressive condition with backward flow from collateral branches in the perineal or inguinal area unconnected to the common femoral. DISCUSSION: The cause of recurrent varicose veins is a question of debate: inadequate or incomplete treatment versus disease progression. Due to the chronic and evolutive nature of varicose veins, duplex Doppler exploration is essential for the preoperative work-up. Follow-up examinations should also be performed every year when the clinical examination suggests recurrence.
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