Background: This study aims to investigate the reasons for postoperative recurrence of varicose veins and anatomical distribution of recurrent venous insufficiency using ultrasonographic and venographic findings.

Methods: A total of 285 legs of 247 consecutive patients who were reoperated due to recurrent varicose veins were retrospectively analyzed. Data were evaluated in terms of clinical characteristics of the patients, symptoms, and vascular imaging methods.

Results: A total of 245 legs (86%) showed perforating vein insufficiency, while 213 (75%) showed reflux of the superficial femoral vein of varying degrees of severity. Residual saphenous vein was recorded in 183 legs (64%), while 11 (4%) legs had iliac vein thrombosis due to previous post-thrombotic syndrome.

Conclusion: Recurrence after varicose vein surgery is multifactorial. As well as unmodifiable factors including age, sex, genetic susceptibility and occupation, inadequate preoperative imaging, limited experience of the surgeon or incomplete surgical intervention and neovascularization during the postoperative period are responsible for the recurrence of varicose veins after the primary surgery. Prevention of varicose vein recurrence after surgical intervention requires a more effective use of preoperative imaging modalities and the best surgical intervention must be planned for each patient before surgery based on the results obtained.

Keywords : Great saphenous vein; perforating vein; recurrent varicose vein; surgery; vein ligation; venous valve insufficiency