Recurrent varicose veins

Health & Wellness

What are the chances of varicose veins returning after treatment?  It is a common problem and most people who are considering having their varicose veins treated ask the question.  The answer depends on the type of treatment that was done and whether it was performed well.  Causes of recurrence include not treating the varicose veins adequately or using the incorrect methods.  If we assume that the initial management was appropriate and that it was properly performed, then the recurrence rate of varicose veins is around 2-3% per annum.

Why do my varicose veins keep coming back? There are a number of reasons why varicose veins come back:

  • Recanalization: Varicose veins are usually caused by a large “axial” vein where the valves are no longer working (the term that is used is “incompetent”).  It is generally one of either the great saphenous, small saphenous or the anterior accessory saphenous veins or a combination. When the first treatment is done, the axial vein is destroyed so that there is no longer any flow through it.  In a small percentage of people, the treated vein can open up again (recanalization) and start feeding new veins, causing the varicose veins to recur.
  • A different feeding vein can become incompetent:  For example, if the varicose veins were initially caused by incompetence of the great saphenous vein, over a period of time, the small saphenous vein or the anterior accessory saphenous vein could become incompetent and feed new varicose veins.  
  • Recurrences can also develop from perforating veins which become incompetent. They are veins which join the deep system to the superficial system (get a description of the venous circulation in the leg here)
  • Neovascularisation: After surgery (and occasionally after thermal ablation), new small veins can develop in the groin.  They feed recurrent varicose veins in the leg from the where the great saphenous vein used to join the common femoral vein.

How can I prevent varicose vein recurrence? Unfortunately, some people have a predisposition to developing varicose veins.  There are genetic causes which one cannot do much about!  But there are some things which can help: maintain a healthy weight, exercise especially walking, avoid prolonged standing. Wearing compression stockings can be helpful, especially if you know you are prone to developing varicose veins.

Should I have my legs checked regularly? If you have had your varicose veins treated, then it is worth having a venous mapping ultrasound regularly, say yearly.  As long as the scan is performed by a properly trained vascular technician, recurrences can be picked up early.  Treatment is then much simpler in most cases.  It is a bit like going to the dentist for a check-up.  If after say 5 years, there is no evidence of recurrences then one could stop the follow-ups because the likelihood of problems is low.

At The Art of Vein Care, we specialise in the management of varicose veins and venous disease.  We offer expert consultations, walk-in walk-out treatment with minimal down time.  If you would like further information, please contact us here:

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