Recurrent varicose veins
Recurrent varicose veins may arise because of new problems at another junction. In the groin they are due to 2 possible causes:
 | Inadequate first time surgery - missed branches that cause problems later. |
| Neovascularisation - this is the growth of new fine veins from the stump of the tied long saphenous vein. |
By 10 years after the first operation about 1 in 5 patients will have recurrent varicose veins. Neovascularisation is currently believed to be the leading cause in the groin.
Second-time operations in the groin increase the risks of damage to the main femoral vein and also of leg swelling as a result of further damage to lymphatic vessels. They should only be performed by surgeons experienced in varicose vein surgery.
Third-time operations in the groin increase the risks even further. Personally I would only consider this surgery in very few cases.
If the long saphenous vein is still present and is being fed by neovascularity, then simply removing the long saphenous vein may be sufficient. This can be achieved with minimal risk using VNUS closure.