Varicose Vein Recurrence and Patient Satisfaction 10–14 Years Following Combined Superficial and Perforator Vein Surgery: A Prospective Case Study

• Published in: European journal of vascular and endovascular surgery Vol. 46; no. 3; pp. 372 - 377
• Main Authors: Nelzén, O, Fransson, I
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2013
• Subjects: Adult; Aged; Aged, 80 and over; Disease Progression; Endoscopy; Female; Humans; Leg - blood supply; Leg - diagnostic imaging; Leg - surgery; Long-term follow-up; Male; Middle Aged; Neovascularization; Neovascularization, Pathologic; Patient Satisfaction; Perforator surgery; Prospective Studies; Prospective study; Recurrence; Reoperation; Saphenous Vein - diagnostic imaging; Saphenous Vein - surgery; Subfascial endoscopic perforator surgery (SEPS); Surgery; Ultrasonography, Doppler, Duplex; Varicose vein recurrence; Varicose vein surgery; Varicose Veins - diagnostic imaging; Varicose Veins - surgery; Long-term follow-up; Perforator surgery; Varicose vein surgery; Varicose vein recurrence; Neovascularization; Patient satisfaction; Prospective study; Subfascial endoscopic perforator surgery (SEPS)
• ISSN: 1078-5884; 1532-2165; 1532-2165
• DOI: 10.1016/j.ejvs.2013.05.022

Objective To assess real long-term varicose vein recurrence and patient satisfaction following surgical intervention with combined subfascial endoscopic perforator surgery (SEPS) and superficial venous surgery. Method Prospective consecutive case study (C3–C4). Patients were included March 1993 to September 1998 and 83/104 legs of 80/100 patients were re-assessed 2008; 71 legs underwent duplex ultrasound scanning (DUS). Results The median follow up was 12 years (range 10–14). Twelve patients/legs had undergone additional vein surgery during follow-up. Incompetent lower leg perforators were noted in 18/71 limbs (25%). Following groin surgery 23/51 (45%) showed a duplex detected groin recurrence, neovascularization dominated 18/23. In legs where primary great saphenous vein (GSV) surgery had been performed, groin recurrence was found in 14/37 (38%). Previously unknown deep vein incompetence was detected in 14/71 legs (20%), six had axial reflux. The correlation between DUS-detected recurrence and remaining symptoms and cosmetic result was low. The overall satisfaction was high, 70/82 (85%). Patient satisfaction did not deteriorate over time ( p  < .557). Conclusion Despite a fair number of DUS-detected recurrences, the overall long-term result, from the patients' point of view was surprisingly favorable. Technically well performed open venous surgery seems to result in a durable long-term outcome.