Abstract
Several events occurring during the 1980s encouraged exploration of video-endoscopic perforator vein interruption during the 1990s. Among these was realization that all of the severe stigmata of the “post-phlebitic” leg could be caused by superficial venous reflux and varicose veins.1,2 This meant that an operation could be offered to patients with severely changed limbs with an expectation of marked improvement of venous function, if not complete cure of the cutaneous manifestations. In addition, duplex technology had revealed that some forms of deep venous reflux could be reversed by ablation of superficial reflux from saphenous veins and varicosities.3,4 This observation implied that removal of refluxing superficial veins improved venous function. Therefore, in limbs with obvious severely deranged venous physiology as shown by marked ankle skin pigmentation with or without ulceration, complete reversal of the pathophysiology might be anticipated.
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