Frequency and Causes of Recurrence after Endovenous Procedures in Patients with Varicose Vein Disease of the Lower Extremities

Objective: To evaluate the frequency and main causes of recurrence following endovenous procedures in patients with varicose vein disease of the lower extremities.

Materials and methods: A retrospective analysis of medical records and outpatient cards of 1,647 patients with varicose vein disease of the lower extremities who underwent endovenous surgery between 2021 and 2025 was conducted. Data analysis was performed using SPSS version 25 and Microsoft Excel.

Results: The recurrence rate within 12 to 36 months after surgery was 3.1% (51 cases). The cumulative recurrence rate increased progressively, reaching 0.18% during the first year, 1.39% during the second year, and 3.1% during the third year. Clinically, recurrences were primarily observed as neoangiogenesis (56.7%) or true recurrent varicose veins (43.1%).

Risk factors for varicose vein recurrence after endovenous procedures included age over 65 years, BMI more than 34 kg/m², a history of type 2 diabetes mellitus (glycated hemoglobin >8%), chronic heart failure of functional class II or higher, the presence of incompetent perforating veins of the thigh and leg, a diameter of functioning tributaries >3 mm in in the thigh and >5mm in the lower leg, the presence of a functioning anterior accessory great saphenous vein with a diameter >3 mm, a Giacomini vein diameter >3.5 mm, a residual stump of the great saphenous vein at the saphenofemoral junction exceeding 1 cm, the exposure power <7 W and laser energy density <80 J/cm², and a great saphenous vein trunk diameter >8 mm.

Conclusion: Identification of the most common risk factors for recurrence of varicose veins after previous endovenous procedures through a comprehensive analysis of clinical, demographic, and instrumental parameters as well as procedural characteristics, allows for the development of a personalized therapeutic approach for each patient and effectively prevents the occurrence of similar complications.

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