Recurrent Varicose Veins and Primary Deep Venous Insufficiency: Relationship and Therapeutic Implications

Abstract

Objective:

Evaluation of the relationship between deep venous insufficiency and recurrent varicose veins (RVV).

Design:

Retrospective analysis of patients affected by RVV submitted to clinical examination, continuous-wave (CW) Doppler, duplex scanning and descending phlebography in cases of incompetence at groin level.

Setting:

Department of Vascular Surgery, Istituto Dermopatico dell'Immacolata (IRCCS), Rome.

Patients:

Two hundred and thirty-nine patients affected by RVV.

Main outcome measures:

CW Doppler ultrasound, duplex ultrasound imaging and descending phlebography to assess venous incompetence.

Results:

Doppler examination revealed no reflux at the groin level in 80 limbs. In the remaining 166 limbs, descending phlebography showed a superficial venous reflux in 95 limbs (related to a sapheno-femoral junction recanalization or to an inadequate previous operation) while in 69 (28% of the 246 limbs examined) deep venous reflux was present (superficial femoral vein in 38 cases, profunda femoris vein in seven cases and both veins in 24 cases); in two cases reflux came from the pelvic veins.

Conclusions:

Our data suggest a possible role of primary deep venous insufficiency in the development of RVV and the value of descending phlebography in the planning of further surgery.

Keywords

Chronic venous insufficiency Deep venous reflux Primary deep venous insufficiency Recurrent varicose veins

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