Endoscopic Subfascial Perforator Interruption And Its Role In Varicose Ulcer Healing

Abstract

Perforator incompetence caused by primary valvular incompetence or by previous deep venous thrombosis, contributes to ambulatory venous hypertension and the development of chronic venous disease. Although the exact role and contribution of perforators to the development of ulcers are still debated, poor results of non-operative management to prevent ulcer recurrence justifY surgical attempts at perforator ligation, in addition to ablation of superficial reflux.

In this study the endoscopic technique of perforator interruption showed high rate of ulcer healing short hospital stay, early ambulation and minimal wound complication ESP! is the perferred method f'lr ablation of perforating veins. Interruption of incompetent perforators with ablation of the superlicial refulx, if present, effectively and durably decreases symptoms of chronic venous insufficiency and rapidly heals ulcers. Color flow duplex examination of the entire lower limb venous system in patients with ulceration can clearly identify patterns of venous abnormalities, follow up to all patient after ESP! by color flow