Stripping of varicose veins
In both of these conditions, varicose veins and “hidden varicose veins” (venous incompetence), the valves inside the veins do not work properly. Therefore when the veins in the legs try to pump the blood back to the heart, it falls back down the affected veins (called venous reflux), causing either inflammation and damage to the skin around the ankle (venous eczema, lipodermatosclerosis, haemosiderin, or leg ulcers) or causes the veins to distend and swell (varicose veins that can lead to bloodclots called phlebitis).
In order to stop this venous reflux, the vein needs to be either blocked or removed. In this way, the operation can stop the blood from falling back down the vein with damaged valves, stopping the damage to the skin and stopping the veins from dilating and becoming varicose.
To understand how veins work, please see our page “how veins work“, and for a deeper understanding, see The College of Phlebology textbook, “Understanding Venous Reflux – the cause of varicose veins and venous leg ulcers“.
Unfortunately, veins are part of the connective tissue of the body and not organs. Generally, when we remove an organ, it is gone for ever. Therefore surgeons used to believe that when they stripped a vein out, it too was gone forever. However prize-winning research from The Whiteley Clinic in 2005, published in the British Journal of Surgery in 2007, showed that when the Great Saphenous Vein was stripped away, 23% of the veins had partially or completely grown back within one year. The same research project has shown that by five years, 82% of these veins have grown back.
Although it might sound good that veins grow back again, unfortunately when veins grow back they never have valves in them. As such when these veins grow back, the varicose veins or problems that the “hidden varicose veins” (venous incompetence or venous reflux) caused recur. This is one of the most common causes of recurrent varicose veins after surgery and as such stripping should never be performed. It is probably safe to say that no true venous expert has stripped the Great Saphenous Vein since 2007 and those that have kept up with the research, for sometime before that too.