Causes and Treatment of Varicose Recurrence in the Popliteal Region

Abstract

Background: In a previous study of 1,081 limbs affected with varicose recurrence (VR) at the saphenofemoral junction (SFJ) and at the sapheno-popliteal junction (SPJ), the anatomical causes were investigated. VR appeared to be due to inadequate diagnosis and surgery; neoangiogenesis appeared to play a minimal role. The so-called cavernoma was secondary to reflux and consisted with a complex collateral circulation (CC). Only 52 of 1,081 (4.8%) studied limbs developed a VR at the SPJ, but the anatomical findings were poorly described. The aims of this study were: 1) to distinguish between VR at the SPJ and the ones caused by different sources of reflux, 2) the reliability of the preoperative DUS examination, and 3) the efficacy and safety of the treatment. Methods: DUS examinations, surgery and sclerotherapy were performed by one single group of physicians. Nineteen of 207 (9.1%) limbs affected with VR at the popliteal region were studied and treated. Most of the previous interventions performed in different vascular units (only one in our center) were high or low interruption +/- stripping of the small saphenous vein (17/19, 89.4%). VRs > 3 mm were treated by surgical high ligation and intraoperative sclerotherapy in 13/19 (68.4%) and short invagination stripping in 1/19 (5.2%); 4/19 (21.0%) with VR 3 mm) at the PR. Sclerotherapy gave satisfactory results in the treatment of the smallest VR (< 3 mm). J Curr Surg. 2017;7(3):27-34 doi: https://doi.org/10.14740/jcs325w