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Strategies for the Management of Incompetent Perforating Veins

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Chronic Venous Disorders of the Lower Limbs

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Abstract

Surgery of incompetent perforators is the bone of contention in phlebology. The precise role and significance of incompetent perforators in CVI is not clearly defined. Most of the studies have combined elimination of saphenous reflux with perforator disconnection. Reports of isolated treatment of perforators are very few. Judgement on the relevance of perforators in the pathogenesis of CVI is extremely difficult on account of these limitations.

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References

  1. Rhodes JM, Kalra M, Gloviczki P. The management of incompetent perforation veins with open and endoscopic surgery. In: Gloviczki P, editor. Handbook of venous disorders. 3rd ed. London: Hodder Arnold; 2009. p. 523–35.

    Google Scholar 

  2. Dodd H, Cockett FB. The pathology and surgery of the veins of the lower limb. 2nd ed. Edinburgh: Churchill Livingstone; 1976.

    Google Scholar 

  3. Labbropoulos N, Delis K, Nicolaides AN, Leon M, Ramaswami G, Volteas N. The role of the distribution and anatomic extent of reflux in the development of signs and symptoms in chronic venous insufficiency. J Vasc Surg. 1996;23:504–10.

    Article  Google Scholar 

  4. Negus D, Friedgood A. The effective management of venous ulceration. Br J Surg. 1983;70:623–7.

    Article  PubMed  CAS  Google Scholar 

  5. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczi ML, Lohr JM, McLafferty RB, Meissner MH, Murad MH, Padberg FT, Pappas PJ, Passman MA, Raffeto JD, Vasquez MA, Wakefield TW. The care of patient with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl):2s–48.

    Article  PubMed  Google Scholar 

  6. Vaidyanthan S. Subfascial ligation of the incompetent ankle perforators (Linton flap procedure) in venous ulcers and stasis dermatitis. Indian J Surg. 1985;47:495–504.

    Google Scholar 

  7. Bergan JJ, Pascarella L. Perforating veins. In: Bergan JJ, editor. The vein book. Amsterdam/Boston: Elsevier; 2007. p. 535–9.

    Chapter  Google Scholar 

  8. Pierik EG, van Urk H, Hop WC, Wittens CH. Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: a randomised trial. J Vasc Surg. 1997;26:1049–54.

    Article  PubMed  CAS  Google Scholar 

  9. Felder DA, Bernstein EF. A re-evaluation of the posterior subfascial approach for the ligation of the communicating veins in the leg. Surgery. 1969;47:349–52.

    Google Scholar 

  10. Healy RJ, Healy EH, Wong R, Schuberg FJ. Surgical management of the chronic venous ulcer: the Rob procedure. Am J Surg. 1979;137(4):556–9.

    Article  Google Scholar 

  11. DePalma RG. Surgical therapy for venous stasis: results of a modified Linton operation. Am J Surg. 1979;137:810–3.

    Article  PubMed  CAS  Google Scholar 

  12. Edwards JM. Shearing operation for incompetent perforating veins. Br J Surg. 1976;63:885–6.

    Article  PubMed  CAS  Google Scholar 

  13. Fischer R. Experience with endoscopic perforator interruption. Phlebologie. 1992;21:224–9.

    Google Scholar 

  14. Gloviczki P. Subfascial endoscopic perforator vein surgery: indications and results. Vasc Med. 1999;4:173–180.

    Google Scholar 

  15. Pierik EGJM, Willens CRA, van Urk R. Subfascial endoscopic ligation in the treatment of incompetent perforating veins. Eur J Vasc Endovasc Surg. 1995;9:38–41.

    Article  PubMed  CAS  Google Scholar 

  16. Gloviczki P, Bergan JJ, Rhodes JM, Canton LG, Harmsen S, Ilstrup DM. Midterm results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial endoscopic perforator surgery registry. J Vasc Surg. 1999;29(3):489–502.

    Article  PubMed  CAS  Google Scholar 

  17. Ten Brook JA, Iafrati MD, O’Donnel TF, Wolf MP, Hoffman SN, Panker SG, Lau J, Wong JB. Systemic review of outcomes after surgical management of venous disease incorporating subfascial endoscopic perforator surgery. J Vasc Surg. 2004;39(3):583–9.

    Article  Google Scholar 

  18. Kumar S, Goswami P, Mukerjee P. Taking up subfascial endoscopic perforator surgery for patients of lower limb varicose veins with below knee perforators, in a Government Medical College – a review of eleven cases. Indian J Surg. 2013;75(6):473–7.

    Article  PubMed  Google Scholar 

  19. Anjay K, Agarwal PN, Pankaj KG. Evaluation of subfascial endoscopic perforator surgery (SEPS) using harmonic scalpel in varicose veins: an observational study. Int J Surg. 2009;7(3):253–6.

    Article  Google Scholar 

  20. Schanzer H, Pierce EC. A rational approach to surgery of the chronic venous stasis syndrome. Ann Surg. 1982;195:25–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Elias S. Percutaneous ablation of perforating veins. In: Gloviczki P, editor. Handbook of venous disorders. 3rd ed. London: Hodder Arnold; 2009. p. 536–44.

    Google Scholar 

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Authors and Affiliations

  1. General Surgery, Amrita Institute of Medical Sciences, Amrita Lane, Kochi, Kerala, 682041, India

    Riju Ramachandran Menon & Subramoniam Vaidyanathan

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  1. Riju Ramachandran Menon
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  2. Subramoniam Vaidyanathan
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Correspondence to Riju Ramachandran Menon .

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Menon, R.R., Vaidyanathan, S. (2015). Strategies for the Management of Incompetent Perforating Veins. In: Chronic Venous Disorders of the Lower Limbs. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1991-0_17

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  • DOI: https://doi.org/10.1007/978-81-322-1991-0_17

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  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-1990-3

  • Online ISBN: 978-81-322-1991-0

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