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Background: Recurrent varicose veins (RVV) occur in 13% to 65% of patients following treatment, and remain a debilitating and costly problem. RVV were initially thought largely to be due to inadequate intervention, however, more recently neovascularization and other factors have been implicated. This review aims to provide an overview of the current understanding of the etiology and pathogenesis of RVV.
Methods: A systematic search of the PubMed database was performed using the search terms including "recurrent," "varicose veins," and "neovascularization."
Results: Three types of RVV have been reported, namely residual veins, true RVV, and new varicose veins, although the definitions varied between studies. RVV are attributable to causes including inadequate treatment, disease progression, and neovascularization. Using duplex ultrasonography, neovascularization has been observed in 25% to 94% of RVV. These new vessels appear in various size, number, and tortuosity, and they reconnect previously treated diseased veins to the lower limb venous circulation. Histologically, these vessels appear primitive with incomplete vein wall formation, decreased elastic component, and lack of valves and accompanying nerves. Although the rate of RVV following open surgery and endovenous treatment appears similar, neovascularization seems less common following endothermal ablation. Other causes of RVV following endovenous treatment include recanalization and opening of collaterals.
Conclusions: Recurrence remains poorly understood following treatment of varicose veins. Neovascularization is an established and common cause of RVV, although other factors may contribute.
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http://dx.doi.org/10.1016/j.jvs.2012.10.102 | DOI Listing |
Ann Vasc Surg
March 2025
Clinical Professor, Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, 100, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Korea. Electronic address:
Objectives: This study aimed to analyze postoperative changes in distal segment reflux after treatment of the proximal segment of an incompetent small saphenous vein (SSV).
Methods: This was a retrospective study of patients treated between April 2017 and July 2022 with a diagnosis of incompetent SSV. Patients who had undergone previous treatment for varicose veins, including sclerotherapy, and those without post-procedure Doppler follow-up were excluded.
Vasc Med
March 2025
Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Venous hypertension due to anatomical venous insufficiency (superficial or deep venous valvular reflux and venous obstruction) and/or functional venous insufficiency (calf dysfunction, dependent edema, lymphatic dysfunction, elevated central venous pressures, etc.) leads to chronic venous insufficiency (CVI) and its sequelae. The most severe clinical manifestation of CVI is venous leg ulcer (VLU), which leads to substantial morbidity and disability.
View Article and Find Full Text PDFAm J Mens Health
March 2025
Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Varicocele is characterized by the abnormal dilation of veins within the testicular pampiniform plexus, contributing to inflammation, pain, and infertility in males. The precise roles of vascular endothelial growth factor receptors (VEGFRs), B-cell lymphoma 2 (BCL-2), and BCL-2-associated X-protein (BAX) in the pathology of varicocele still need to be clarified. This study sought to investigate the protein expression levels of VEGFR1, VEGFR2, VEGFR3, BCL-2, and BAX in varicose and healthy vessels from patients diagnosed with varicocele.
View Article and Find Full Text PDFInflammopharmacology
March 2025
Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt.
The occurrence of venous diseases among adults is approximately 77% in females and 57% in males. These conditions are prevalent, progressive disorders that significantly affect individuals socially, physically, and psychologically, often resulting in various venous abnormalities that hinder effective blood circulation in the lower limbs. This review provides a comprehensive overview of venous diseases, focusing on their pathophysiology, symptoms, causes, risk factors, diagnosis, and complications.
View Article and Find Full Text PDFJ Surg Res
March 2025
Department of Vascular Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China. Electronic address:
Introduction: This study aimed to assess the midterm efficacy and symptoms of sclerosing foam combined with endovenous laser ablation in treating lower-extremity varicose veins.
Methods: This study analyzed 838 patients (985 limbs) with varicose veins in one or both lower extremities, treated at our center from September 2020 to June 2022. All patients underwent sclerosing foam combined with endovenous laser ablation.
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