Neovascularization in Recurrence of the Varicose Great Saphenous Vein following Transection

Abstract

Recurrence of varicose veins after surgical treatment is widely attributed to morphological and haemodynamic changes in pre-existing collateral veins. Transection of the great saphenous vein in the thigh under local analgesia was used to promote healing of varicose ulceration. When healing was complete, saphenofemoral ligation combined with stripping or multiple ligation was performed. At the same time the vascular changes at the site of transection were investigated in 10 patients by phlebography, surgical exploration and examination of the excised vessels by radiographic and histological methods. The results showed that the continuity of the vein was restored by growth of new vessels in the surrounding tissues and vein wall. Some vessels increased in size, developing smooth muscle and elastic tissue in their walls, while the majority underwent regression. It was concluded that the theory of recurrence through pre-existing veins requires revision.