The Clinic is Closed

Why Veins Come Back After Vein Surgery

I received a very interesting question via the website from a lady called Heather in Dorchester. She said that she had had her veins treated 20 years ago and that they had come back even worse than ever – why was this and could she have anything done about it?

veins recurring (coming back) after vein surgery
Recurrence After Vein Surgery

Well, about 30% of people I see now have already had vein treatment and their veins have recurred. And there are 3 main reasons why this happens Heather.

The first is that they had inadequate treatment at the initial procedure. Either they had the wrong procedure done, or they had the correct procedure done incorrectly. Now let me explain a bit about that. In my opinion, everyone should have an ultrasound scan before they have anything done to their veins at all. An ultrasound will allow the specialist to look at the deep veins, the superficial veins and their connections and with this information specialist will be able to identify the root cause of the vein problem. Once the specialist has this information he can then formulate a treatment plan. It is also very important that the treatment itself is guided by ultrasound actually during the procedure. So the specialist can confirm that the correct veins are being treated. Also, after the treatment and at the follow-up visit ultrasound should be used to confirm that the procedure that was intended has in fact been done satisfactorily. So, by using ultrasound in these 3 ways, at the initial assessment, during the procedure and at the follow-up you get better initial treatment.

The second reason why veins can come back Heather is a process called neovascularization. Now this is a fancy medical term just to say that the veins regrow after the older traditional procedures such as surgical stripping. Now until we had ultrasound scans readily available surgeons didn’t really believe that veins could regrow after they had been tied and removed. But we now know that this is a particular feature of surgical stripping and veins will regrow the raw ends want to re-grow and rejoin. And this is a very important cause of recurrence. Fortunately, it is not a feature of the newer treatments that we have on offer.

The third reason why veins recur is a genetic pre-disposition.Unfortunately, veins tend to run in families and people can inherit a weakness of their veins from their parents and there is very little you can do about that. However, there are things you can do in terms of lifestyle changes. You can watch your weight, perhaps avoid standing for long periods of time and you can consider wearing good quality medical grade compression hosiery. All these things will reduce the chance of veins recurring after satisfactory treatment. But there’s nothing you can really do about any genetic predisposition to veins that you might have inherited from your parents. So there it is Heather those of the 3 main reasons why veins come back and I think in your case you probably had an inadequate procedure because 20 years ago we were not using ultrasound scans very widely and you had a procedure surgical stripping which does tend to stimulate neovascularization.

Can you have more treatment? Well yes of course you can. If veins have recurred and you have faulty valves in those veins and you’ve got a condition called reflux then we can identify that accurately with ultrasound and we can make sure that any future treatment is targeted at those veins. So thank you for that question Heather. That’s one of the commonest questions that I get asked in fact and I am glad to be able to help you with that


Contact me today for a confidential chat

If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone or email for free and without obligation.

The VeinCare Centre also offers a screening assessment with our vascular technologist. For £25 you can have a scan with Wendy Parsons. She is not a doctor and so she could not give you medical advice but she can check your deep veins and your varicose veins and give you an idea of how bad they are and what treatment options might be available. If you would like to have an appointment with Wendy please call 0800 698 3467.