Among 542 patients with recurrence after saphenous vein removal, we found that 143 (26%) had a new reflux point in the thigh. After withdrawal of the saphenous vein another vein becomes diseased and transfers its flow to veins in the thigh (like a network).
Studies suggest that high collateral pressure due to loss of drainage causes recurrence. Being practical, we could use an old adage adapted: “Dead vein, vein put”.
The saphenous in the thigh has an importance in the conduction of blood from the superficial to the deep. If it does not exist and a new vein becomes diseased, the flow of this vein drains into the deep slowly. This creates varicose collaterals to try to drain away somewhere. We see cases where the patient loses his saphenous vein and creates countless vessels to compensate.
To make a parallel, the saphenous vein is like a car trip at a highway and the collateral is the same trip going inside all the cities.