Varicose veins that occur in many common body locations, mostly in the legs, are caused by malfunctioning valves inside the veins. When these valves do not work as they should, instead of moving blood back to the heart, the blood pools in the veins, causing varicose veins. There are several different treatments of varicose veins, including surgery.
While most patients experience excellent results from surgery and other treatment to get rid of varicose veins, varicose veins do recur. The recurrence of varicose veins after treatment, even after surgery, is a common problem. The recurrence rate of varicose veins after surgery, is reported to be between 20% and 80%, with about 60% being the norm. So, why do varicose veins recur? Here are some reasons…
- Inadequate Procedures: The initial procedure to remove and eliminate varicose veins may have been faulty or inadequate. It is important to conduct a duplex ultrasound examination before treating varicose veins, especially surgically. If a duplex ultrasound is not performed, perforators, accessory veins, small saphenous extensions, and pelvic escape points are usually overlooked. Your doctor should have a protocol in place that includes careful examination and documentation of all possible sources of reflux that could easily be missed. This will go a long way in preventing the recurrence of varicose veins.
- Recanalized Veins: Treated varicose veins may recanalize or open up again. This results in these veins supporting blood flow again. Some treatments have a lower risk if recanalization. You should consult your vascular surgeon for suggestions, recommendations, and treatment.
- Neovascularization: This results in the development of new blood vessels. It is especially common after some treatments, such as after stripping of the vein. Neovascularization is challenging to treat. This is because the new vessels are very thin-walled, usually present in multiples, and may also have scar tissue from previous treatment. This makes them particularly prone to complications, such as bleeding, lymphatic injury, and infection. Thermal treatment options are not possible to treat this, as the blood vessels are too tortuous for catheters. The most common treatment for these blood vessels is Sclerotherapy.
- Abdominal and Pelvic Incompetence: Pelvic and abdominal veins that have been missed or have newly occurred may result in the recurrence of varicose veins in the lower body and legs. A diagnosis of this can be made by duplex ultrasound or possible venography. Ultrasound guidance during the treatment of these veins can help considerably.
- Obstructive Disease: If you have a history of Deep Vein Thrombosis (DVT) and post-thrombotic syndrome, the chances are high for the recurrence of varicose veins. This is because deep venous obstruction can result in recurrent varicosities. Patients with these conditions should be considered for venography and intravascular ultrasound. Once a diagnosis has been made as to which veins are impacted, they could be treated with venous angioplasty and stents with good, long-term results.
- Treatment of the wrong veins: Varicose veins that are seen on the surface of your skin are the result of varicose vein problems, not the cause. It is important that the right veins be treated and this can be done by using Duplex Ultrasound Scanning of the veins. Rather than just a couple of veins being the underlying cause, several veins may be contributing to the problem. It is imperative that your doctor understands which veins are resulting in varicosity.
- Use of wrong techniques: It is important that your doctor uses the right technique to treat your varicose veins. If the wrong technique is used, the veins will grow back. However, when this new vein occurs, it does not have any valves, so the problem of blood pooling in the vein occurs again. Inadequate treatment causes thrombosis or clots, which closes the vein temporarily. This veins will reopen in the future, when the thrombosis or clot dissolves. This is why the best scanning technique should be used and the best treatment should be prescribed for varicose veins to prevent their recurrence in the future.
- New varicose veins forming: This takes place because veins that were previously working at the time of treatment subsequently become varicose. This is often called “disease progression”. While this takes place in a small number of patients, it is a very real occurrence.
- Some risk factors are unresolved: While the original treatment procedure to treat your varicose veins may have been successful, there is a chance that you may again develop varicose veins due to certain risk factors. These include obesity and pregnancy. During your subsequent pregnancy, your varicose veins may recur. However, your doctor can advise you as to how to manage these risk factors.
- Your condition may be progressive: Some people may have a strong genetic predisposition to varicose veins. If this is so, you may not be permanently “cured” of your varicose veins. However, your vascular surgeon can help develop a treatment strategy to address your current symptoms. The right initial treatment can reduce your risk of developing more varicose veins in the future.
As with all vascular disease, choosing the right vascular surgeon to treat your varicose veins is key to the successful resolution of your problem. Dr. Abhilash Sandhyala, of the Flow Vascular Clinic, is one such vascular surgeon. He is based in Hyderabad, India, and is particularly adept at treating varicose veins.
He will work closely with you to determine the cause of your varicose veins and why they recur, if at all. He will also treat you as a complete individual and will prescribe the treatment for your varicose veins that is right for you.
Dr. Sandhyala has successfully treated thousands of patients with varicose veins and this number continues to grow. So, if you need to treat recurring varicose veins, you should definitely consider consulting Dr. Sandhyala for the complete resolution of your problem!
For more information about recurring varicose veins, as well as the treatment for DVT, or other vascular conditions, contact Dr. Abhilash Sandhyala at (+91) 9989649498 or 9959033037, or at [email protected] or visit our website at www.drabhilash.com
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Dr. Abhilash Sandhyala · Flow Vascular Clinic, Kukatpally, Hyderabad