EVALUATION OF THE RESULTS OF PHLEBECTOMY WITHOUT LIGATION OF INCOMPETENT PERFORATING VEINS IN PRIMARY VARICOSE VEINS OF LOWER EXTREMITIES

Abstract

Current approach to operative treatment of varicose veins of lower extremities doesn’t suggest interventions on perforating veins due to the fact that they restore their function following surgery in majority of cases. The article presents the results of 2-year of follow-up study after phlebectomy without ligation of perforating veins the shin in patients with varicose veins of lower extremities C2-C3. Localization and extension of venous reflux were evaluated by duplex scanning. The main sign of incompetent perforating vein is a retrograde blood flow more than 0,5 sec. Varicose tributaries of incompetent perforating veins were preoperatively marked and removed using Muller’s hooks in zone not more than 1 cm from perforating vein. Postoperative duplex scanning showed 1 /3 of all perforating veins (surgery mainly resulted in Cockett ligation of perforating veins above mascular fascia). Visual signs of varicose disease relapse weren’t noted at examination of the patients, but according to duplex scanning the retrograde blood flow on perforating veins in proximal compression was kept in 45,1% of cases.