Operative Procedure Of Ultrasound-guided Percutaneous Ablation Of Multiple Perforator Veins
Takahiro Imai, chief.
Nishinokyo Hospital, Nara, Japan.
OBJECTIVE - When a perforator vein valve is incompetent, high “systolic” intravenous pressures in the calf veins (about 20mmHg) are transmitted to the superficial skin circulation causing white cell trapping and capillary cuffing and impairment of nutritional skin flow. They can cause skin pigmentation, lipodermatosclerosis, finally venous leg ulcer formation. METHODS - We refer to the guidelines of the Society for Vascular Surgery: SVS/ America Venous Forum: AVF (2011) to determine the indications for operation. Specifically, operation was performed in cases where the IPV size was greater than 3.5mm in diameter and in cases where the diastolic reflux duration from the deep into superficial was greater than 500 msecs. RESULTS - From July 2021 to January 2022, single Percutaneous Ablation of Perforators: PAPs was performed in 45 (8.9%) of 504 patients with varicose veins. Multiple PAPs were performed in 5 of 45 patients. A 1470 nm Laser device was used for this operation. The operation time was 7±3.1 minutes for single PAPs and 14±6.5 minutes for multiple PAPs. The average occlusion rate half a year after operation was 76.6±9.9%. CONCLUSIONS - This operation method can be performed in a short period of time, about 15 minutes, and relatively good postoperative results were obtained. In this time, I make a video presentation about our multiple PAPs operation.
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