الفهرس 
Anatomy of Venous System of the Lower LimbOnly 14 pages are availabe for public view
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Abstract
Recurrent varicose veins of lower limbs, re-appearing in the short- or long-term after previous treatment, are a common problem after surgery, the incidence of clinical recurrence is estimated to be between 25% and 50%.
The main causes for varicose vein recurrence after treatment are:
• Inadequate preoperative assessment due to insufficient understanding of venous anatomy and haemodynamics,
• Incorrect surgical intervention if the wrong vein has been treated, incomplete or too low ligation at the saphenofemoral junction.
• Deep venous reflux due to incompetent valves of deep venous system allowing blood to move from the deep to the superficial system.
• Neovascularization as a result of angiogenic stimulation in the stump endothelium and dilation of small adventitial vessels.
Clinical examination after varicose vein operations has a very poor sensitivity and specificity in detecting recurrent venous reflux.
With the widespread use of duplex ultrasound for evaluation of patients with varicose veins the impact of recurrence is diminished nowadays.
Duplex ultrasound is recommended as a safe, non-invasive and accurate method of evaluating recurrent varicose veins, which demonstrates the complicated anatomy of recurrent varicose veins. In addition, it provides functional information about the patterns of recurrent venous reflux.