Neovascularization in the groin: treatment options

Neovascularization is a formation of new blood vessels, which can occur in an abnormal tissue or position. These new vessels arise in the granulation tissue along the track of previously stripped or ligated veins. They form between the common femoral vein and the residual stump of the great saphenous vein or its tributaries. These new blood vessels are found relatively frequently, even after correct functional ligation. Neovascularization is a common cause of recurrent varicose veins, accounting for 8% to 60% of all cases. Neovascularization is thought to be pathologic angiogenesis. Angiogenesis is the sprouting and expansion of new blood vessels from existing vessels. Neovascularization in the groin is a condition characterized by numerous tortuous veins in the area of the saphenofemoral junction. Usually occurring after previous interventions on the veins in this area. Treatment of neovascularization in the groin is challenging due to changed anatomical conditions, scars, and adhesions in this area. In the treatment, we use thermoablation if there is an incompetent stump of the saphenous vein or the anterior accessory saphenous vein. We also use ultrasound-guided sclerotherapy, which is suitable for recurrent, tortuous, and anatomically atypical veins. We often use hybrid methods. It is very important to carefully examine the veins with Doppler ultrasound before and after the procedures to achieve optimal treatment outcomes.