Influence of perforating vein surgery in patients with venous ulceration

Gent, W.B. van; Wittens, Cees H. A.

doi:10.1177/0268355513517685

Cited by 24 publications

(18 citation statements)

References 25 publications

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“…A secondary analysis of the Dutch SEPS trial on 94 ulcerated legs was reported with a mean followup of 29 months. 353 Ulcer recurrence was significantly higher in patients who had an incomplete SEPS procedure (P ¼ .007), indicating the clinical significance of incompetent perforating veins in patients with venous ulcers. …”

Section: Guideline 61 Superficial Venous Reflux and Active Venous Lementioning

confidence: 94%

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

O’Donnell¹,

Passman²,

Marston³

et al. 2014

Journal of Vascular Surgery

575

450

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Section: Guideline 61 Superficial Venous Reflux and Active Venous Lementioning

confidence: 94%

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

O’Donnell¹,

Passman²,

Marston³

et al. 2014

Journal of Vascular Surgery

575

450

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“…After the treatment of PV reflux around the ulcer, the ulcer healed well, and the recurrence rate was low. [20–24]…”

Section: Discussionmentioning

confidence: 99%

Factors related to the size of venous leg ulcers

Liu

Zheng²,

Ye³

et al. 2019

Medicine

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“…The significance of perforators, their contribution to venous symptoms including ulcer and role of treating them in case of primary varicose veins is disputable. Many studies favour the fact that incompetent perforators contribute to chronic venous disease and need treatment, 5,[14][15][16][17][18] while some disagree. 19,20 The role of incompetent perforators in recurrent or persistent disease and requirement of their treatment are less controversial and there are many supporting studies, some of which have shown incompetent perforators to be the most common cause of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Treatment of incompetent perforators in recurrent venous insufficiency with adhesive embolization and sclerotherapy

Joy

Toms

et al. 2017

Phlebology

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Recurrent lower limb venous insufficiency is often a challenge in clinical practice and is most commonly due to incompetent perforators. Many of these patients do not have adequate symptom relief with compression and require some form of treatment for incompetent perforator interruption. Various treatment methods have been tried with different efficiencies. Objective To evaluate the feasibility, efficiency and safety of an outpatient combined cyanoacrylate adhesion-sodium tetradecyl sulphate sclerotherapy for treatment of patients with symptoms of persistent or recurrent lower limb venous insufficiency secondary to incompetent perforators. Methods Eighty-three limbs of 69 patients with symptoms of persistent or recurrent lower limb venous insufficiency secondary to incompetent perforators were treated with cyanoacrylate embolization of incompetent perforators and sclerotherapy of dilated collateral veins (surface branch varicose veins). Technical success, procedural pain, perforator occlusion, venous occlusion, clinical improvement and ulcer healing were assessed. Follow-up was done three- and six-month post-procedure. Results Procedure could be successfully performed in all patients. One hundred and ninety-one perforators were treated in total. Perforator and varicose veins occlusion rate was 100%. Deep venous extension of cyanoacrylate occurred in four (4.8%) patients, with no adverse clinical outcome. Venous clinical severity score improved from a baseline of 8.18 ± 3.60 to 4.30 ± 2.48 on three-month follow-up and 2.42 ± 1.52 on six-month follow-up (p < 0.0001). All ulcers showed complete healing within three months. Significant prolonged thrombophlebitis occurred in 38.5% of limbs. Conclusion Combined cyanoacrylate adhesion and setrol sclerotherapy is technically easy, has a lot of advantages including being an outpatient procedure and highly efficacious but with a guarded safety profile.

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Influence of perforating vein surgery in patients with venous ulceration

Abstract: In this series a well-performed SEPS procedure lowers the venous ulcer recurrence rate significantly, indicating the clinical importance of incompetent perforating veins in patients with an active venous ulcer.

Cited by 24 publications

References 25 publications

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

Factors related to the size of venous leg ulcers

Treatment of incompetent perforators in recurrent venous insufficiency with adhesive embolization and sclerotherapy

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