Update in Doppler ultrasound of lower limbs in case of recurrent varicose veins

Abstract

Recurrent varicose veins of lower limbs, re-appearing in the short- or long-term after previous treatment, are a common problem after surgery, the incidence of clinical recurrence is estimated to be between 25% and 50%. The main causes for varicose vein recurrence after treatment are: • Inadequate preoperative assessment due to insufficient understanding of venous anatomy and haemodynamics, • Incorrect surgical intervention if the wrong vein has been treated, incomplete or too low ligation at the saphenofemoral junction. • Deep venous reflux due to incompetent valves of deep venous system allowing blood to move from the deep to the superficial system. • Neovascularization as a result of angiogenic stimulation in the stump endothelium and dilation of small adventitial vessels. Clinical examination after varicose vein operations has a very poor sensitivity and specificity in detecting recurrent venous reflux.