What are perforators in veins?
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.
How do you treat an incompetent perforator?
Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources.
What are communicating veins?
Perforator veins are also known as communicating veins because they transport the blood directly from the superficial veins to the deep veins, connecting two parallel systems: the superficial venous system, and the deep venous system, somewhat like the rungs of a ladder connecting the two side rails.
What is perforator vein ablation?
Perforator vein ablations are for the treatment of leg venous ulcers and skin changes. Chemical ablation is the injection of medication via a needle into unwanted veins. The goal is to irritate and scar the veins from the inside such that these abnormal veins close and no longer fill with blood.
How many perforator veins are there?
About 150 perforating veins have been identified, and they are grouped based on their location. However, only about 20 of them have been shown to become incompetent and are frequently found in patients with ulceration.
What does incompetent vein mean?
Venous insufficiency is a medical condition in which veins in the body (most often in the legs) are not able to pump blood back to the heart. This causes blood to pool in the blood vessels so that they become enlarged (varicose) or dilated over time.
What are perforating or communicating veins?
Perforator veins are defined as veins that communicate between superficial and deep veins by “perforating” the deep fascia.
Are perforator veins deep 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….
| Perforator vein | |
|---|---|
| Latin | Venae perforantes |
| Anatomical terminology |
Where are the paratibial perforators located in the thoracic spine?
The paratibial perforators connect the great saphenous vein to the posterior tibial veins. Multiple paratibial perforators are found 2–4 cm posterior to the medial edge of the tibia or “Linton’s Lane” and are particularly important for conducting a proper SEPS procedure.
Where are incompetent perforators found in the leg?
Incompetent perforators usually are observed at the medial thigh, middle and distal third of the leg, and mid third of the calf. 6,13 Scanning of the lateral aspect of the lower limb also is recommended.
Where are the distal posterior tibial perforators located?
The most distal posterior tibial perforators (Cockett I) are located behind the medial malleolus, and the middle and upper posterior tibial perforators are located more proximally in the calf (at 7-9 cm and 10-12 cm from the medial malleolus, respectively) and about 2.5 cm medial to the tibia.
What kind of perforators are encountered during SEPs?
All perforators encountered are divided with the harmonic scalpel. The perforators encountered during SEPS include the upper, middle, and lower posterior tibial perforators and the proximal paratibial perforators.
