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Pelvic venous reflux is a major contributory cause of recur..:

Whiteley, Alice M. ; Taylor, Daniel C. ; Dos Santos, Scott J..
Journal of Vascular Surgery: Venous and Lymphatic Disorders.  2 (2014)  4 - p. 411-415 , 2014
Link: https://doi.org/10.1016/j.jvsv.2014.05.005