Related Experiment Videos
New insights into perforator vein incompetence
N Labropoulos1, M A Mansour, S S Kang
1Division of Vascular Surgery, Loyola University Medical Center, Maywood, IL, USA.
Summary
The number and diameter of incompetent perforator veins (PVs) increase with chronic venous disease (CVD) severity. Incompetent PVs most often exhibit outward flow and are linked to superficial vein reflux, not primary deep vein issues.
Area of Science:
- Vascular Surgery
- Phlebology
- Medical Imaging
Background:
- The role of perforator veins (PVs) in chronic venous disease (CVD) is debated.
- Understanding PV flow dynamics is crucial for diagnosing and managing CVD.
Purpose of the Study:
- To investigate the flow duration and direction of lower limb PVs.
- To correlate PV characteristics with their location, diameter, and superficial/deep vein competency in healthy individuals and CVD patients.
Main Methods:
- Color-flow duplex scanning of 103 limbs in 75 CVD patients and 30 limbs in 15 healthy volunteers.
- Analysis of superficial, perforator, and deep veins in standing and sitting positions.
- Determination of PV flow velocity, number, diameter, and competency (outward flow >0.5s).
Main Results:
- Incompetent PVs (28%) were found only in CVD patients, increasing with disease severity.
- Incompetent PVs were larger in diameter than competent ones, with subfascial diameter >3.9mm indicating incompetence.
- Outward flow was predominant in incompetent PVs (77%) and strongly associated with superficial venous reflux (74%).
Conclusions:
- PV incompetence and diameter increase with CVD severity.
- Bidirectional PV flow is more prevalent in CVD patients.
- Superficial vein reflux is the primary cause of PV incompetence, with deep venous reflux being a less common primary factor.