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Do Varicose Veins Recur?

Do Varicose Veins Recur - Cover image

Yes, varicose veins can recur after treatment. Varicose veins are swollen, twisted veins that usually occur in the legs. They are often caused by weakened valves in the veins, which can lead to blood pooling and the development of varicose veins.

Treatment for varicose veins typically involves procedures such as endovenous laser treatment (EVLT), radiofrequency ablation (RFA), microwave ablation, sclerotherapy, or surgical interventions. These treatments aim to close or remove the affected faulty veins and redirect blood flow to healthier veins.

While these treatments can be effective in reducing the appearance and symptoms of varicose veins, it is important to note that they do not guarantee permanent elimination of the condition. Varicose veins can recur for several reasons:

  1. Incomplete Treatment: If the initial treatment does not fully address all the affected veins, there is a possibility of recurrence. Proper evaluation with a pre-operative Duplex ultrasound and thorough treatment of all diseased veins are important to minimize the risk of recurrence.

  2. New Vein Formation: Even after successful treatment, new varicose veins can develop over time. This may occur due to the progression of underlying venous insufficiency or the development of new weak valves in previously unaffected veins.

  3. Risk Factors: Certain risk factors can increase the likelihood of varicose vein recurrence. These include a family history of varicose veins, obesity, pregnancy, hormonal changes, prolonged standing or sitting, and a sedentary lifestyle. Managing these risk factors can help reduce the chances of recurrence.

  4. Lifestyle Factors: Poor lifestyle habits, such as lack of exercise, smoking, and a diet high in processed foods, can contribute to the development and recurrence of varicose veins. Adopting a healthy lifestyle that includes regular exercise, maintaining a healthy weight, and consuming a balanced diet can help prevent recurrence.

What are the recurrence rates of varicose veins?

recurrence rates of varicose veins

The recurrence rate of varicose veins can vary depending on various factors, including the type of treatment used and the underlying causes of the condition. Here are some estimates of recurrence rates for different treatment options:

  1. Surgical Stripping: Surgical stripping, which involves removing the affected vein through incisions, has been associated with higher recurrence rates. Studies have reported recurrence rates ranging from 25% to 60% within 5 years after surgery.
  2. Endovenous Ablation Techniques: Minimally invasive procedures such as endovenous laser treatment (EVLT) and radiofrequency ablation (RFA) have shown lower recurrence rates compared to surgical stripping. Recurrence rates for these procedures range from 5% to 20% within 5 years.
  3. Sclerotherapy: Recurrence rates for sclerotherapy can vary depending on the type of sclerosant used and the size of the varicose veins. Studies have reported recurrence rates ranging from 10% to 40% within 5 years after sclerotherapy.

It is important to note that recurrence can occur even after successful treatment, as new varicose veins may develop over time due to underlying venous insufficiency or other risk factors. Additionally, individual factors such as genetics, lifestyle choices, and the presence of other medical conditions can influence the likelihood of recurrence.

Even with recurrence, you may not need reintervention depending on the severity and extent of recurrence and the skin condition of your legs.

What are the treatment options for recurrent varicose veins?

The treatment options for recurrent varicose veins are similar to those for initial varicose veins. The specific treatment approach will depend on the individual case and the underlying causes of the recurrence. Here are some common treatment options for recurrent varicose veins:

  1. Endovenous Laser Treatment (EVLT): EVLT uses laser energy to close off the affected vein. It is a minimally invasive procedure that involves inserting a laser fibre into the vein and delivering heat to seal it shut. EVLT is effective in treating both initial and recurrent varicose veins.

  2. Radiofrequency Ablation (RFA): RFA is a procedure similar to EVLT but uses radiofrequency energy instead of laser energy. It also aims to close off the diseased vein and redirect blood flow to healthier veins. RFA is often used for larger varicose veins and can be an effective treatment for recurrent cases.

  3. Sclerotherapy: Sclerotherapy involves injecting a foam or liquid solution directly into the affected vein. This solution irritates the vein lining, causing it to collapse and eventually be reabsorbed by the body. Sclerotherapy is commonly used for smaller varicose veins and can be an effective treatment for recurrent cases.

  4. Microphlebectomy: Microphlebectomy is a surgical procedure that involves removing the affected vein through small incisions. This procedure is typically used for larger varicose veins that cannot be effectively treated with minimally invasive techniques. Microphlebectomy can be an option for recurrent varicose veins that have not responded to other treatments.

  5. Compression Therapy: Compression stockings or bandages are commonly recommended as a conservative treatment for varicose veins. They help improve blood flow and reduce symptoms. Compression therapy can be used in combination with other treatments for recurrent varicose veins to provide additional support and reduce the risk of further recurrence.

If varicose veins do recur, it is important to consult with a vascular specialist to determine the best course of action. They can evaluate the underlying causes and recommend appropriate treatment options to manage the recurrence effectively. They can determine the most appropriate treatment option for recurrent varicose veins.

Dr Tang is highly regarded for his specialised clinical interests and skills in a wide range of vascular conditions.
Dr Wong is highly regarded for his specialised clinical interests and skills in a wide range of vascular conditions.

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