Olle Nelzen,Ingvor Fransson,
A One-Year Audit of Varicose Vein Surgery at a Vascular Surgical Unit with a Long-Term Duplex and Quality of Life Follow-Up
Surgical Case Reports
2021
2613-5965
http://dx.doi.org/10.31487/j.SCR.2021.07.15
https://www.sciencerepository.org/a-one-year-audit-of-varicose-vein-surgery_SCR-2021-7-115 
Abstract: Objective: With the introduction of endovenous treatments, open varicose veins surgery was discarded due to a claimed high risk of neovascularisation. A one-year audit was set up to look at results from performing mainly open surgery.
Methods: All varicose vein interventions were registered and prospectively followed with colour Duplex assessments after 4-6 weeks, 1 and >5 years. In addition, Aberdeen Varicose Vein Questionnaire (AVVQ) was used in addition to Varicose Vein Severity Score (VCSS) to assess patients’ quality of life (QoL) and the disease severity. 
Results: During the year, 236 patients/252 legs were operated and 28% were re-do procedures. Median age was 55 years (16-87) and 70% were females. Duplex at 4-6 weeks showed a primary success rate of 91%. Neovascularisation was noted in 8% one year after primary surgery. The long-term assessment was done after a median of 69 months (39-75) and 67% of all legs were examined. After primary surgery 16% showed neovascularisation compared with and 27% after re-do procedures. VCSS improved significantly from 6 (range 1-22) to 2 at the long-term follow-up (p<0.001). The AVVQ score improved from 20 (range 3-55) down to 10 (p<0.001). 
Conclusion: The risk for neovascularisation seems to have been overestimated and good long-term results can be achieved following modern open surgery. The major problem is to avoid varicose vein recurrence since results from re-do procedures seem less favourable long term.
Keywords: Varicose veins, varicose vein surgery, varicose vein recurrence, audit, quality of life