Recurrent varicose veins after short saphenous vein surgery: a duplex ultrasound study

Causes and Treatment of Varicose Recurrence in the Popliteal Region

“…Before examining our cases, we reviewed the more recent literature where the causes of VR at the PR have been described: incomplete diagnostic and surgical procedures, recanalization after sclerotherapy or endovascular treatments and the neonagiogenetic hypothesis [24,[27][28][29][30][31][32][33]. The importance of performing a complete investigation of the anatomical causes of VR at the PR recently led some authors to employ the threedimensional computed tomography venography [34].…”

“…Therefore, a high Varicose Recurrence in the Popliteal Region J Curr Surg. 2017;7(3): [27][28][29][30][31][32][33][34] attention was dedicated to the SFJ where a detailed description of every single anatomical finding was reported on the bases of the official nomenclature [3]. At the opposite, a lower interest for the VR at the SPJ/PR led to a poor anatomical description.…”

Short Saphenous Varicose Vein Associated with Incompetent Gastrocnemius Vein

“…On the other hand, the disappearance of gastrocnemius vein incompetence after long saphenous vein surgery has also been reported [17]. However, the management of the incompetent gastrocnemius vein accompanying a short saphenous varicose vein has so far only rarely been discussed [5,18,19]. Therefore, when a short saphenous varicose vein before surgery is associated with an incompetent gastrocnemius vein, then the effect of ligating the gastrocnemius vein while performing simultaneous short saphenous vein surgery in order to reduce recurrence remains to be elucidated.…”

“…The previous reports that analyzed recurrent cases documented the major causes of recurrence to be the incomplete or wrong division of the sapheno-popliteal junction, remaining of tributaries at its root and neovascularization reconnecting the superficial veins to the popliteal vein [3][4][5][6][7][8][9]. Although several studies also noted the presence of an incompetent gastrocnemius (sural) vein in recurrent cases [5,10,11], there have so far been no reports indicating that an incompetent gastrocnemius vein may be the cause of the recurrence after short saphenous varicose vein surgery. In addition, the suitability of ligation of the gastrocnemius vein is unknown when recurrence after short saphenous varicose vein surgery is associated with an incompetent gastrocnemius vein.…”

The Incidence, Clinical Importance and Management of Incompetent Gastrocnemius Vein

“…3) So far, an 'incompetent GCV' has been described in some reports which surveyed the venous status of the legs after varicose vein surgery [4][5][6][7] or of legs having chronic venous disease. [8][9][10][11][12][13][14] However, the incidence, clinical importance and management of an incompetent GCV have rarely been discussed.…”