PMC5960849_01
Photograph of right leg showing recurrent varicose veins arising from groin.
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In 2018, she presented with a 2-year history of recurrent varicose veins in her right thigh, medial right knee and upper right leg (Figure 1).
(a) Venous ultrasound showing primary avalvular varicose anomalies (PAVA) tissue in right groin within the saphenous fascia:GSV and AASV previously ablated:arrows showing the different PAVA vessels. (b) Same patient showing PAVA passing into and out of a lymph node (lymph node between crosses).
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The new recurrent varicose veins were found to be arising from the profuse PAVA tissue in the groin (Figure 2(a) and (b)). The PAVA tissue was predominantly in the groin, within the saphenous fascia (Figure 2(a)) and associated with a lymph node (Figure 2(b)) and so could be classified as both "truncal" and "lymph node" pattern.