[Echo Doppler classification of postoperative recurrence of varicose veins in the region of the internal saphenous vein].
OBJECTIVE
Surgical treatment of varicose veins of the lower limbs is frequently complicated by recurrence. Although recurrence was long thought to result from technical errors, certain patients have progressive disease.


METHODS
We used duplex-Doppler to assess 102 patients (160 limbs) with recurrence after resection of the saphene-femoral junction with stripping of the internal saphenous vein and the varicose network on the medial aspect of the leg. A vein map was established to classify recurrences.


RESULTS
Type I, junctional stump with incontinent collateral, was observed in 22.5% of the cases. Type II, sapheno-femoral junction in an anatomic position, was found in 18.1%. Type III, backward flow from a perforating vein or a collateral of the common femoral was found in 13.1% and type IV, cavemomous aspect, in 7.5%. In 45% of the cases, the patient had a progressive condition with backward flow from collateral branches in the perineal or inguinal area unconnected to the common femoral.


CONCLUSIONS
The cause of recurrent varicose veins is a question of debate: inadequate or incomplete treatment versus disease progression. Due to the chronic and evolutive nature of varicose veins, duplex Doppler exploration is essential for the preoperative work-up. Follow-up examinations should also be performed every year when the clinical examination suggests recurrence.
Hôpital Notre Dame de Bon Secours, Paris.
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D012008:Recurrence; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018608:Ultrasonography, Doppler; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*
Classification écho-Doppler des récidives variqueuses post-opératoires du territoire saphène interne.