Changes in Perforating Vein Reflux after Saphenous Vein Ablation

Abstract

Introduction

This prospective duplex study evaluates what percentage of perforators remains incompetent after saphenous vein ablation by endovenous laser ablation (EVLT).

Methods

Patients with venous disease, incompetent perforating veins (IPVs), and saphenous vein reflux identified on initial duplex ultrasound exam were included. Perforators were re-evaluated 3 days postoperatively for size and competency.

Results

One hundred patients with a mean age of 53 years with incompetent saphenous veins and a total of 169 IPVs were included. Of the 169 initially incompetent perforators, 92 (54.4%) became competent, 21 (12.5%) occluded, and only 56 (33.1%) remained incompetent after the EVLT procedure. When grouped by diameter, 25 (89.29%) of small-diameter perforators (<3 mm), 49 (62.03%) of medium-diameter perforators (3–4 mm), and 18 (29.03%) of large-diameter perforators (>4 mm) became competent after the EVLT procedure. Only 3 of the 28 (10.7%) small-, 23 of the 79 (29.1%) medium-, and 30 of the 62 (48.4%) large-diameter perforators remained incompetent after the EVLT procedure. Preoperative perforator diameter was a determining factor in reversal of reflux (p < 0.0002).

Conclusion

Only 33% of all initial incompetent perforators remained incompetent after the EVLT procedure. Reversal of incompetence was size dependent.