February 11


Varicose Veins Revisions

By Dr. Jose Almeida

February 11, 2019

A varicose vein surgery revision is the need for another procedure due to failure of the original procedure.

Varicose vein revisions are performed when previously treated veins have scarred down and re-open, which leads to blood flow through the prior treated vein. There are several procedural treatment options to treat varicose veins, such as sclerotherapy, vein stripping, and endovascular therapy, that can be completed with either a laser or radiofrequency. 

The endovascular and sclerotherapy procedures have an excellent success rate with there being about 95% success with treating the varicose veins, where as vein stripping has about a 50-80% chance of success. 

What may cause the need for Varicose Vein Revisions?

Although there is high success with sclerotherapy or endovascular therapy, there are still specific reasons that may cause the need for revision, or a repeat of treatment, which are:

  • an inadequate initial procedure​
  • new blood vessels forming​
  •  opening of the prior treated vein​
  • new areas of vein incompetence

1. Inadequate Procedures

Inadequate procedures are usually preventable with the use of an ultrasound, called a Duplex, to identify all of the veins with malfunctioning valves or weakened walls. This allows for adequate treatment of all of the varicose veins.  The duplex is used at evaluation and at the time of the procedure to identify all of the veins, so that the larger veins, but also the smaller veins, that contribute to the large veins, are all treated appropriately during the procedure. 

2. New Blood Vessels

The body is resilient with the formation of new blood vessels in body tissues, as veins are destroyed or removed with treatment. This more commonly occurs after vein stripping surgery, but may still happen after endovascular or sclerotherapy treatments.  The new blood vessels are usually formed within the scar tissue from the procedure. There are usually multiple new veins that have very thin walls, that can easily exhibit symptoms of varicose veins.

Call 305-930-8941 or click here to book a consultation at the Miami Vein Center.

3. Opening of the Prior Treated Vein

Veins that were previously treated and have scarred down, can re-open, which leads to blood flow through the prior treated vein. Depending on how much the vein re-opens, this can allow for a normal amount of blood flow, causing similar problems in the vein as before the procedure was performed.

4. New Areas of Vein Incompetence

Since varicose veins have a genetic component, new areas of incompetent veins can be found in the legs, abdomen, or pelvis. These may have been missed on prior Duplex examination, but commonly other areas can begin to have valves that are no longer functioning, leading to varicose veins in other locations.

Is Revision Surgery Necessary?

The cause of the recurrence of varicose veins, current symptoms, and the initial treatment used will all determine if further treatment is necessary and what type of treatment will be best to treat the recurrent symptoms. A Duplex examination will be necessary to determine the cause or causes for the recurrence, as well as other potential imaging. 

In some cases, if there are minimal symptoms, no treatment may be necessary, but rather consistent follow up for the possibility of worsening symptoms and need for further treatment.  

Common Symptoms of Varicose Veins

What to do if you feel varicose veins are returning.

If you are experiencing symptoms of varicose veins, such as swelling, bulging, heaviness, or cramping, after having a varicose vein procedure, you should visit with your doctor to determine the source and further treatment options that may be available.

Dr. Jose Almeida, a board certified surgeon, at the Miami Vein Center is a leading expert in the care of varicose veins. He has years of experience helping patients prevent, treat and manage the complications of varicose veins and will help you get any varicose vein revisions you may need. 

Call 305-930-8941 or click here to book a consultation at the Miami Vein Center.

Dr. Jose Almeida

About the author

Dr. Jose Almeida, MD, FACS, RPVI, RVT is a veteran academic vascular surgeon who practices Endovascular Venous Surgery in Miami, FL. He is also a Diplomate of the American Board of Surgery in both Vascular Surgery and General Surgery.

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