Invasive Treatment of Recurrent Varicose Veins in Patients with Femoral Vein Incompetence

Recurrence of varicose veins is common in vascular surgery. Superficial femoral vein incompetence is one of the important causes of recurrent varicose veins. Objective. To improve the outcomes of surgery for recurrent varicose disease in patients with femoral vein incompetence. Material and methods. There were 164 patients with recurrent varicose veins including 49 (30%) men and 115 (70%) women. Mean age was 43 years. Patients were divided into two groups: group 1 — patients with reflux in superficial femoral vein; group 2 — patients without deep vein reflux. The 1st group was subdivided into subgroups: 1a — microsurgical reconstruction of the femoral vein valve with concomitant phlebectomy; 1b — phlebectomy alone. In the 2nd group, varicose veins were removed in standard fashion. Results. Long-term follow-up confirmed better results in patients without deep reflux (group 2). There were worse results in subgroup 1b compared to subgroup 1a. Results in subgroup 1a and group 2 were comparable (favorable outcomes in 90% and 93.1% of cases, respectively). On the contrary, long-term results were unfavorable in subgroup 1b. Quality of life significantly improved in all groups. Our data demonstrate significant impact of femoral vein incompetence on postoperative outcomes in patients with recurrent varicose veins. Conclusions. Microsurgical reconstruction of typical incompetent femoral vein valve significantly improves the results of surgery for recurrent varicose veins.