What are Perforators in varicose veins?
Perforator veins are so called because they perforate the deep fascia of muscles, to connect the superficial veins to the deep veins where they drain. Perforator veins play an essential role in maintaining normal blood draining.
What is perforator ligation?
The technique is based on subfacial ligation of perforating veins through a small skin incision (2.3 cm). This procedure allows a fast healing of surgical wounds and a good esthetical result. The subfacial ligation allows a complete cure of the disease in primary varicose veins and avoids the main causes of recurrence.
What is ligation of varicose veins?
Ligation means the surgical tying of veins through a small incision in the skin to prevent pooling of blood. Ligation may be used in conjunction with vein stripping, or removal of the vein. In many instances, the vein is removed using a minimally invasive surgical procedure called venous ablation.
Which perforator is located in distal thigh?
In the distal third of the thigh, a perforating vein, formerly known as the Hunter perforating vein, is found.
How many perforators are in the lower limb?
Although there are 150 perforating veins (PVs) in the lower extremity (LE), only a few of them are clinically significant [5]. Perforators are located between the deep and the superficial veins [great saphenous vein (GSV), small saphenous vein (SSV), anterior or posterior accessory GSV or VVs].
Do perforators have valves?
Perforator veins have one-way valves designed to prevent backflow of blood down towards the superficial veins. When those valves no longer function properly and reflux occurs, the buildup of blood and pressure can cause not only the superficial veins but the perforators themselves to become incompetent.
What is perforator incompetence?
Perforator vein incompetence generally follows reflux within the superficial veins in a temporal fashion, supporting the former theory (9,14). Pathologic perforator veins are described as having reversed flow from deep system to superficial vein for more than 500 ms, and with diameter more than 3.5 mm.
What is subfascial endoscopic perforator surgery?
What is subfascial endoscopic perforator surgery (SEPS) for venous disease? SEPS is a minimally invasive surgical technique used to treat chronic venous ulcers caused by perforating veins that may have been damaged due to deep vein thrombosis or chronic venous insufficiency.
What is Saphenofemoral ligation?
Conclusion: The isolated ligation of saphenofemoral junction is a minimally invasive, safe and effective modality for treatment of chronic leg ulcer, and being easily performed under local anesthesia and considered to be a satisfactory procedure for treatment of leg ulcer in patients who are unfit for general …
What is high saphenous ligation?
High ligation is a medical term that refers to tying off a vein through surgical methods to prevent blood flow into a diseased or non-functioning vein. The vein most likely to undergo a ligation procedure is the great saphenous vein, which is the large, superficial vein that runs from the groin into the foot.
What are perforators in lower limb?
The perforating veins of the lower limb (PV or “perforators”) are so called because they perforate the deep fascia of muscles, to connect the superficial venous systems of the lower extremity with the deep veins where they drain. There are numerous veins in variable arrangement, connection, size, and distribution.
Are perforator veins tributary veins?
There is one more set of important veins of the legs termed the Perforator Veins (sometimes referred to as Connector Veins). The leg has approximately 100 of these perforator veins to connect the superficial tributary veins and trunk veins to the deep veins in the muscle.
Where are the perforator veins in the lower leg?
Cockett perforators – located in the calves The superficial lower limb veins empty into the deep limb veins through the perforator veins which then returns the venous blood back to the heart. Perforator veins have one-way valves designed to prevent the backflow of blood from the deep lower limb veins to the superficial limb veins.
What are the causes of perforator venous insufficiency?
This leads to the reflux of blood from the deep venous system to the superficial venous system. One cause of perforator venous insufficiency is the weakness of the perforator veins at the juncture where the perforator veins connect with the superficial veins known as re-entry points.
What is a direct perforating vein?
The perforating veins referred to here are the so-called ‘direct’ perforators – defined as those veins which perforate the deep fascia of the limb to enter directly into a main deep vein (such as the femoral or posterior tibial). These veins are few in number and in definite regular anatomical sites.
Can varicose veins be treated with perforator venous reflux?
Treatment of varicose veins, reticular veins, and spider veins can fail if an underlying perforator venous reflux disease goes unnoticed. The treated varicose veins or spider veins can recur if the perforator reflux is not treated.