RVAS
Recurrent Varicosities After Surgery (RVAS)
In our practice we frequently see patients who have had previous vein stripping or ligation. Unfortunately, recurrences of varicose veins are common after previous vein ligation stripping and avulsion. Current theories of why varicose veins recur after previous vein ligation and stripping relate to the concept of neovascularization. This is especially common after a formal saphenofemoral junction (where the superficial and deep vein meet in the groin) dissection and ligation, a technique that was common until recently. Neovascularization occurs when the veins from the abdomen and pelvis are dilated with gravity and ultimately coalesce to form new, large varicose veins in the legs. While early studies suggest that the newer endovenous approaches to obliterating the saphenous vein leads to significantly less neovascularization because the saphenofemoral junction is left intact, long term studies are not yet available to prove this assumption. Vascular Ultrasound is an excellent way to assess these often complex patterns, and both ambulatory phlebectomy and ultrasound guided sclerotherapy can be very effective forms of treatment for recurrent veins.
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