Cryoperforator surgery: a new treatment of incompetent perforating veins

This study was conducted to determine the feasibility of cryoperforator surgery in the treatment of incompetent perforating veins. Fifteen patients with C2-C4 varicose disease (according to the Clinical-Etiology-Anatomy-Pathophysiology classification) were enrolled in this study. Under local anesthesia, incompetent perforating veins were treated with a duplex-guided cryoprobe. Duplex scans were performed 2 and 4 weeks after treatment. Fifteen patients with 28 incompetent perforating veins were treated with cryoperforator surgery. Distribution of the incompetent perforating veins was as follows: posterior tibial perforator, 12; paratibial perforator, 11; intergemellar perforator, 1; lateral leg perforator, 4 (range = 1-5 incompetent perforating veins per patient). Follow-up showed successful treatment of 12 incompetent perforating veins (43%). This study showed that cryoperforator surgery is feasible for treatment of incompetent perforating veins. Higher success rates could be obtained with our modified diamond-dust coated cryoprobe. Major advantages are the treatment in an outpatient setting and the possibility of treating all incompetent perforating veins, intraluminal or extraluminal.