Duplex ultrasound assessment of neovascularization after sapheno-femoral or sapheno-popliteal junction ligation

Objective: Evaluation of neovascularization at the saphenous ligation site as a cause of recurrent varicose veins. Design: Prospective duplex study of a single patient group. Setting: Vascular clinic of a University Hospital. Patients: 131 patients (177 limbs) were evaluated 2 and 12 months after varicose vein surgery. Intervention: Clinical assessment and colour duplex scanning of operated limbs. Main outcome measures: Limbs were classified according to the degree of neovascularization: grade 0 = no new communicating vein, grade 1 = new communicating vein with diameter <4 mm, and grade 2 = new communicating vein with diameter >4 mm and pathological reflux. Results: Two months postoperatively, grade 0 was observed in 173 limbs (98%) and grade 1 in four limbs (2%). Twelve months postoperatively, 152 limbs (86%) scored grade 0, 16 limbs (9%) grade 1 and nine limbs (5%) grade 2. Conclusions: After correctly performed previous surgery, neovascularization of varying degree may occur within 1 year, as can be demonstrated on postoperative duplex examination.