RECURRENT VARICOSE-VEINS AND PRIMARY DEEP VENOUS INSUFFICIENCY - RELATIONSHIP AND THERAPEUTIC IMPLICATIONS

Objective: Evaluation of the relationship between deep venous Insuffic iency and recurrent varicose veins (RVV). Design: Retrospective analys is of patients affected by RVV submitted to clinical examination, cont inuous-wave (CW) Doppler, duplex scanning and descending phlebography in cases of incompetence at groin level. Setting: Department of Vascul ar Surgery, Istituto Dermopatico dell'Immacolata (IRCCS), Rome. Patien ts: Two hundred and thirty-nine patients affected by RVV. Main outcome measures: CW Doppler ultrasound, duplex ultrasound imaging and descen ding phlebography to assess venous incompetence. Results: Doppler exam ination revealed no reflux at the groin level in 80 limbs. In the rema ining 166 limbs, descending phlebography showed a superficial venous r eflux in 95 limbs (related to a sapheno-femoral junction recanalizatio n or to an inadequate previous operation) while in 69 (28% of the 246 limbs examined) deep venous reflux was present (superficial femoral ve in in 38 cases, profunda femoris vein in seven cases and both veins in 24 cases); in two cases reflux came from the pelvic veins. Conclusion s: Our data suggest a possible role of primary deep venous insufficien cy in the development of RVV and the value of descending phlebography in the planning of further surgery.