Pressure changes occuring during the activity of the calf muscle venous pump are the driving force of venous hemodynamics in the lower extremity. An ambulatory pressure gradient arises between the veins of the thigh When varicose veins recur, the recurrent reflux volume remains significantly lower for many years of follow-up as compared with the situation before surgery. External banding of incompetent valve in the long saphenous vein and the CHIVA-method are less efficient in comparison with standard surgery (crossectomy plus stripping). Sclerotherapy is a usefull supplement to surgery during follow-up, as it is able to improve significantly the hemodynamic situation. This improvement is only transitory, but sclerotherapy can be repeated and the improvement re-established, if necessary, during follow-up.

        Key words: varicose vein surgery – venous hemodynamics