More than 25 million people are affected by varicose veins or chronic venous insufficiency in the United States with only 1.9 million seeking treatment. This leaves the vast majority of people undiagnosed and untreated. Without treatment, those with the disease may experience progressive symptoms such as swollen, heavy or painful legs. The onset of these symptoms gradually lead to a more sedentary lifestyle, with a decrease in overall wellness and quality of life.


When patients undergo varicose vein surgery or treatment, they expect that they have had the right operation or procedure using the right techniques and so their veins should be fixed. However it is commonly considered that varicose veins sometimes come back again. If this is true then there appears to be something wrong with varicose vein surgery or procedures. Research has established not only why varicose veins come back again in some patients and after some treatments but also how to prevent this from happening.


There are two main reasons as to why varicose veins come back again after treatment. These are:

  • The wrong veins were treated
  • New varicose veins formed due to more valves failing


The varicose veins that are seen on the surface of the skin are the result of varicose vein problems, not the cause. To understand the cause of varicose veins, we need to know which underlying veins have lost their valves and are causing the varicose veins seen on the surface. Most doctors and medical students are not particularly interested in varicose veins. Most medical schools still teach junior doctors that varicose veins only come because valves fail in either the great saphenous vein (GSV) or the small saphenous vein (SSV). Doppler ultrasound scanning has been available for over a decade and this technology has allowed us to understand veins and varicose veins far better than we ever had before. This has also shown us that the old understanding was incorrect. Rather than just two veins being the underlying cause, we now know that the incompetent perforating veins and other abnormal veins can be responsible for varicose veins. In addition, it might not be just one of these veins but it may be any combination of them. It is rare for any two patients with varicose veins to have the same pattern of disease. As such, in order to treat all the veins correctly, it is essential to have a thorough doppler ultrasound scan performed here at the Alpha Vein Clinic by our trained technician to look for all these different veins. Such a scan will take at least 30-45 minutes per leg.

Most vein clinics perform quick scans, lasting only a couple of minutes , so it is not surprising that many of the underlying causes of varicose veins are missed. For the most part the technicians are not well trained to recognize the diseased veins. It has become clear that doppler ultrasound diagnosis of which veins are causing a problem has become of paramount importance in getting good varicose vein treatment. Quick scans performed either cheaply or even for free are a false economy. Saving money on a scan, which turns out to be inadequate, only leads to the wrong veins being treated and recurrent varicose veins. Although research and experience has shown us that we have demonstrated excellent closure rates of veins that we have treated even in the long term , there are many patients that we see from other clinics or hospitals who think they have had the same techniques, but when they are scanned, the veins are still there and dysfunctioning.


The second reason for recurrent varicose veins, or the veins to come back again after treatment, is that the veins that were previously working at the time of the treatment subsequently become varicose. A way to describe this is: Imagine going into your local town today and stopping 100 adults at random. You then scan them using doppler ultrasound and find that none of them have any varicose veins or hidden varicose veins. If you then check all of these people again in one year, some of them will have now developed varicose veins.

That is the rate of disease progression of varicose veins. In people who have had varicose veins treated before, the risk of getting varicose veins in other veins in their legs is approximately 3 to 4.5% a year. The good veins will take over the duty of closed veins and there is a possibility that those good veins lose their good valves and have leakage through the valves.  Therefore, perfect treatment should result in a recurrence rate of between 3.0 and 4.5% per year after treatment. It is impossible to get below this rate as this is the natural disease progression. Dr. Sassan Kaveh will use a Doppler Ultrasound to accurately diagnose the reason behind your varicose veins. If you opt for a procedure, it will be performed in our comfortable, accessible vein clinic in Las Vegas and you’ll be able to go back to your normal routine within a day or two. Call us today at (702) 430-7661, and come visit us in Las Vegas! Our dedicated staff will guide you every step of the way.

Alpha Vein Clinic


3150 N. Tenaya Way Ste. 400

Las Vegas, NV, 89128

(702) 430 7661

Dr. Sassan Kaveh

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