[Use of a crochet hook for stripping incompetent, perforating veins as an adjunct to sclerosant therapy]

If during the course of sclerosant treatment an incompetent perforating vein situated along the course of a varicose trunk is not obliterated, or alternatively recanalises just after a temporary obliteration, the therapeutic phlebitis has an irregular appearance, being hard and solid in its proximal course, weak or even absent at the point of leakage, and soft and inflamed below it. At this level there often develops a periphlebitis of long duration, followed by recurrence of the varicosity. In such cases the author attacks the incompetent perforator using a hook. Analysis of 68 ruptures carried out in this way (15 on perforating veins on the medial side and 37 on "Cockett 3") shows that this small operation is quite harmless and rapidly improves the quality of the sclerosis.