Possibilities to prevent recurrent varicose veins after surgery

Abstract

The high rate of groin recurrences in varicose vein surgery has established a need for methods to prevent them.

The use of different barrier techniques in the groin helps in reducing the reflux rate to 1.5 and 3 % within two to five years after the primary operation.

Electrocoagulation of the stump endothelium with suturing of the lamina cribrosa and extensive crossectomy with stump oversuturing represent the most simple techniques. Even so, recurrence at the saphena femoral junction cannot be prevented in all cases. The remodelling hypothesis of varicose vein genesis, which includes chronic inflammatory processes, as well as further factors associated with recurrence seem to play a significant role in the pathophysiologic process. Therefore, in addition to barrier techniques conservative anti-inflammatory procedures should also be included in the therapy program: Vein-conscious lifestyle with compression-therapy, avoiding long sitting and standing, endurance sports and in case of obesity reduction of visceral fat tissue. Studies addressing this nonsurgical type of recurrence prevention are lacking.

Key words

Varicose vein surgery - recurrent varicose veins - neoangiogenesis - barrier techniques - remodelling hypothesis

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