Status of Treatment Considering the Transition of Treatment Methods for Varicose Veins of the Lower Extremities and the Characteristics of Their Recurrence Type

Abstract

It is internationally called REVAS (recurrent varices after surgery) regarding recurrent varicose veins. A consensus meeting on the topic decided to adopt a clinical definition: the presence of varicose veins in a lower limb previously operated on the varices. Causes of REVAS include inappropriate surgery based on inadequate preoperative evaluation (tactical error), inappropriate or incomplete surgical procedure (technical error), regurgitation due to neovascularization at the blood flow blockage site, and varicose vein progression including residual varicose veins at a site different from the surgical site (disease progression). In some cases, REVAS could be avoided by treatment strategies, such as improper surgical procedure selection based on incorrect diagnosis and poor surgical procedures. In addition, when REVAS is diagnosed, each case shows a unique venous regurgitation, and many cases cannot be dealt with by routine standard surgery. More detailed examination, surgical procedure selection, and prominent surgical technique are required for these reasons than in the initial surgery.