Determinants and patterns of recurrence of primary varicose veins after Endovenous laser ablation

Background: The goal of this retrospective cohort study was to determine the different recurrence patterns, sites and determinants impacting primary varicose vein recurrence after endovenous laser ablation (EVLA).Methods: 127 symptomatic patients (127 limbs) with great saphenous vein incompetence who underwent EVLA were followed up for recurrence. Twenty-seven patients were lost to follow-up, leaving 100 patients (100 limbs) for analysis. Outcomes: Recurrence defined by venous clinical severity score (VCSS) or patterns of reflux on the duplex ultrasound examination. Assessments were done at 1, 6, 12 and 24 months after the procedure.Results: Two-year life table analysis showed varicose vein recurrence in 9(7.1%) of limbs. Varicose vein recurrence was due to refluxing anterior accessory saphenous vein in 77.8% patients (p <0.001, 95% CI 3.2 to 1669.1), re-canalization (66.6%), non-truncal varicosities (55.5 %) and incompetent perforators 77.8% patients (p <0.001, 95% CI 2.7 to 69.3).Recurrence was mostly seen owed to both incompetent perforators and accessory saphenous vein, BMI more than 30.5 kg/m2 is noted in 77.8 % (p <0.001, 95% CI 1.105 to 1.590) of recurrence patients.