Mg. De Maeseneer et al., Clinical relevance of neovascularisation on duplex ultrasound in the long-term follow-up after varicose vein operation, PHLEBOLOGY, 14(3), 1999, pp. 118-122
Objective: To evaluate the clinical relevance of neovascularisation at the
saphenous ligation site.
Design: Long-term follow-up after previous varicose vein surgery in a singl
e patient group.
Setting: Vascular clinic of a university hospital.
Patients: Eighty-two patients (106 limbs) with a mean follow-up period of 5
6 months after correct saphenous ligation were submitted to duplex scanning
.
Intervention: Clinical assessment and colour duplex scanning of all the ope
rated limbs. Intervention in 15 limbs with perioperative evaluation of recu
rrent veins.
Main outcome measures: Limbs with and without recurrent varicose veins were
classified according to the degree of neovascularisation: grade 0 = no new
communicating veins, grade 1 = tiny new vein with diameter <4 mm, grade 2
= new communicating vein with diameter >4 mm and pathological reflux. On re
intervention the presence of neovascular veins at the site of the previous
ligation was checked.
Results: In 68 limbs without recurrent varicose veins, grade 0 was observed
in 50 limbs (74%), grade 1 in 12 limbs (18%) and grade 2 in six limbs (9%)
. In 38 limbs with recurrent varicose veins, grade 0 was diagnosed in eight
limbs (21%), grade 1 in four limbs (11%) and grade 2 in 26 limbs (68%). In
15 limbs with recurrent varicose veins and grade 2 neovascularisation, rei
ntervention confirmed the duplex findings.
Conclusions: The presence of grade 2 neovascularisation was associated with
the recurrence of varicose veins, suggesting a causal relationship.