Varicose Vein Surgery Revisions
Revision is never a word that anyone wants to hear, particularly after a medical procedure. Educate yourself on the possible needs for revision after your varicose vein treatment procedure.
Varicose veins have been treated for many years with a surgical procedure called vein stripping, but in the recent years have been treated with less invasive procedures, such as sclerotherapy and endovascular treatments. Vein stripping has had a much lower success rate with about 20-50% of patients needing revision surgery versus only about 5% revision rate with the less invasive procedures.
When is Revision Needed?
Revision is needed when there are recurrent symptoms, such as swelling, heaviness, or cramping after having a varicose vein procedure. The majority of the time, the recurrence usually occurs years after the initial procedure.
But what causes varicose veins after they have been treated?
1. Neovascularization
This is a medical term for the formation of new blood vessels. After blood vessels have been removed from stripping, or the vessels have been scarred after sclerotherapy or endovascular treatment, new blood vessels form to help facilitate the movement of blood. Usually a lot of the vessels form and are weak with very, thin walls, found within the scar tissue. This is more common after vein stripping, than either sclerotherapy or endovascular treatment.
2. Recanalization
This is a medical term meaning that an area that was previously closed, reopens. After sclerotherapy or endovascular treatments, that cause scarring of the vein, this scarring can recanalize, allowing for blood flow to occur through the vein. In some instances the blood flow is minimal, but in others, the blood flow could be close to normal, causing recurrent symptoms.
3. Insufficient Procedure
This could be due to misidentification of veins prior to having a procedure or this could be due to having a procedure with a professional that does not have the appropriate board certified training in the treatment of varicose veins. The use of Duplex has largely reduced insufficient procedures. Duplex is a special type of ultrasound used on the legs to locate the veins and determine which veins need treatment. With the use of Duplex, these veins can be located and treated appropriately at the time of the initial treatment.
4. New Varicose Veins
These new varicose veins may be located in other areas of the legs or in the abdomen or pelvis. These may have been missed on initial evaluation with ultrasound at treatment. Often, due to varicose veins being hereditary, this usually means that the veins in other locations begin to develop non-functioning valves with stretching of the veins, leading to new areas of varicose veins.
Important Points about Revision Surgery
Revision surgery all depends on what caused the recurrence and the treatment that was initially used. The revision surgery is usually more difficult than the first treatment, due to scar tissue and prior scarring of the veins. It is important to have an evaluation with a board certified physician to determine the cause and the best treatment option.
Meet ABMS Board Certified Surgeon, Dr. Mackay
Contact the office of Dr. Edward Mackay, a board certified vascular surgeon providing services to patients in the Tampa area.