Diagnosis and current management of incompetent perforator veins

For nearly a century, surgeons have recognized that incompetent perforator veins (IPVs) likely play a role in the development of venous pathology. Although surgical management of IPVs has improved significantly since Linton first described his approach in 1938, little evidence exists that clearly defines the role of IPV interruption as a modern treatment for complicated venous insufficiency of the lower extremity. The purpose of this article is to review the literature in an attempt to clarify the role for IPV therapies as either adjunct or independent treatment for complicated venous insufficiency. Additionally, a summary of IPV diagnosis, patient selection, and current ablative therapies will hopefully serve as a guide for surgeons who manage venous disease.