Varicose Vein Surgery Revision
Revision is never a word that anyone wants to hear, particularly after you’ve already recovered from a medical procedure. When used in a medical context, “revision” means to surgically correct, or revise, some undesirable outcome of a previous surgery.
Revision may be needed if a patient experiences recurrent symptoms, such as leg pain and swelling, heaviness, or muscle cramping after already having undergone a varicose vein procedure. Most of the time, symptoms recur years after the initial procedure.
Less Invasive Procedures Reduce the Risk of Revision
All surgical and nonsurgical procedures carry a risk of the need for revision at some later date. However, advances in technology and techniques have brought those risks way down – especially in recent years.
For example, varicose veins have been treated for many years with a safe and effective surgical procedure called vein stripping. It is estimated that about 20% - 50% of patients who underwent vein stripping will eventually require a revision surgery. Today, however, less invasive procedures – such as sclerotherapy, laser treatment, and radiofrequency ablation – carry a mere 5% revision rate.
Why Varicose Vein Symptoms May Return
The following are common reasons varicose veins and its symptoms may recur at some point after a previous treatment for varicose veins.
Neovascularization
Neovascularization is the medical term for the formation of new, albeit weaker and less capable blood vessels. After blood vessels have been removed via vein stripping – or the vessels have been sealed shut after sclerotherapy, laser treatment, or radiofrequency ablation – new blood vessels form to help facilitate the movement of blood. However, many of these vessels are weak with very thin walls, increasing the risk of additional varicose veins. Neovascularization is more common following vein stripping than the other minimally invasive approaches.
Recanalization
Recanalization describes the reopening of an area that was previously closed. For example, after vein ablation, the scarring induced by the ablation may recanalize, allowing for blood flow to occur. The amount of blood flow may be minimal or return to normal amount, which causes the varicose vein symptoms to recur.
Insufficient Procedure
Varicose veins may return due an incomplete previous treatment. This could happen through misidentifying which veins required treatment (treating veins that didn’t require it, or missing veins that did). Using ultrasound imaging – especially duplex ultrasound, which can measure the movement of blood inside blood vessels – has helped to reduce the occurrence of insufficient procedures. Still, relying on a medical professional who is not a vein specialist with advanced training and certification in the field will increase your risk of needing revision varicose vein surgery.
New Varicose Veins
Another reason for revision surgery is if new varicose veins have developed since the previous treatment. These issues may have been missed on initial evaluation, or the new varicose veins may be located in other areas of the leg, abdomen, or pelvis. This is especially common among people who are genetically or otherwise prone to develop varicose veins.
Important Points about Revision Surgery
The type of revision surgery required will depend on the cause of the recurrence as well as what type of varicose vein treatment was originally used. A revision surgery is usually more difficult than the first treatment due to the presence of scar tissue and the prior scarring of the veins.
Should you require revision varicose vein surgery, consult with an expert in the field – someone like board-certified vascular surgeon Dr. Edward G. Mackay at Edward G. Mackay and Associates, LLC in Tampa Bay, Florida. To schedule your appointment, call us at (727) 781-5652 or use our appointment request form now.
