Article

Efficacy of subfascial endoscopy in eradicating perforating veins of the lower leg and its relation with venous ulcer healing.

Department of Surgery, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Journal of Vascular Surgery (impact factor: 3.21). 09/1997; 26(2):255-9. pp.255-9
Source: PubMed

ABSTRACT The purpose of this study was to investigate the efficacy of subfascial endoscopy by use of a mediastinoscope in the identification and ligation of incompetent perforating veins in patients with venous ulceration of the lower leg.
All patients who underwent subfascial endoscopy for venous ulceration between Jan. 1, 1994, and Mar. 1, 1995, at the Sint Franciscus Gasthuis in Rotterdam underwent duplex ultrasound scans of the lower leg before and 6 weeks after operation. The number and localization of the perforating veins on the mediodorsal side were compared with the findings during subfascial endoscopy.
In 20 patients, preoperative duplex examination showed 46 incompetent and six competent perforating veins. During operation the site of 43 incompetent and all competent perforating veins was confirmed. Five additional perforating veins were found at operation (false-negatives). Postoperative duplex ultrasound scans showed six incompetent perforating veins (four persisting and two recurring perforating veins) in four patients, of which the ulcers did not heal in three. The ulcers of the other 17 patients healed.
Subfascial endoscopy is an efficient technique in identifying incompetent perforating veins in patients with chronic ulceration of the lower leg. The persistence of incompetent perforating veins is related to failure of ulcer healing.

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Keywords

17 patients
 
20 patients
 
43 incompetent
 
46 incompetent
 
6 weeks
 
additional perforating veins
 
chronic ulceration
 
competent perforating veins
 
duplex ultrasound scans
 
efficient technique
 
incompetent perforating veins
 
lower leg
 
mediodorsal side
 
perforating veins
 
Postoperative duplex ultrasound scans
 
preoperative duplex examination
 
Sint Franciscus Gasthuis
 
subfascial endoscopy
 
ulcer healing
 
venous ulceration