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Coil Embolization offers a simplified technique for treatment of venous perforator incompetence.
Charles S. Joels, MD, Chris J. Lesar, MD, L. Richard Sprouse, MD, Mark W. Fugate, MD, Sachin V. Phade, MD.
UT Chattanooga, Chattanooga, TN, USA.
OBJECTIVES:
Perforator incompetence is a common, but difficult to treat, aspect of CVI. The currently described therapies are cumbersome, often costly, and require specialized equipment which can limit the treatment venue. This study presents a novel, simplified technique that overcomes these obstacles.
Methods:
In this study incompetent venous perforators were treated in seven patients (eight legs) using venogaphy and coil embolization. All patients were symptomatic (edema, ulceration, recurrent cellulitis). In all but one patient the diagnosis was made with preoperative duplex. Demographic and clinical data were reviewed retrospectively.
Results:
Venograms were performed after accessing the appropriate tibial vein in the lower leg and pushable coils deployed within the incompetent perforator using fluoroscopic guidance. All patients were treated on an outpatient basis, all but one in an office setting. Procedure success was 80% with two legs requiring multiple interventions. Symptom resolution by treated leg was 75%. One leg had persistent ulceration, another persistent edema. There were no DVT's or other significant complications.
CONCLUSIONS:
Coil embolization offers an effective, low cost, less cumbersome, minimally invasive technique to treat perforator insufficiency in an outpatient setting.
 
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