Veins provide the transfer of dirty blood from organs and tissues to the heart. There are three vein systems, deep, superficial and perforating. Deep veins carry 80-90% of blood and 10% of superficial blood.
These veins contain valves that allow blood to flow from the leg to the heart and prevent back-escape. It is called venous insufficiency that these valves reclaim blood for various reasons.
Figure. Deep (Upper), superficial (Lower) veins
There are two-leafed valves in the veins and they allow blood to flow only towards the heart, preventing blood from escaping. It is found in the connecting (vein: perforator) veins that allow the transition between deep and superficial veins. These have valves that only allow passage from the surface to the deep.
Figure 3.4: Vein valves
Figure 4. Vein pressure change
Figure 5. Capillaries or large varicose veins due to leaks in the groin area
Capillaries or large varicose veins develop due to leaks especially in the groin area where deep and superficial veins meet.
Venous insufficiency classification
Class 0. No visible problems
Class 1. Capillaries
Class 2. Wide heirs
Class 3. Leg edema
Class 4. Ankle discoloration (darkening)
Class 5. Healed ulcer in the ankle
Class 6. Active ankle in the ankle
Picture. Class 1-6
What should we do to reduce the venous insufficiency complaint?
What to do in the treatment of venous insufficiency?
Perforating Vein Failure and Treatment Approaches
Deep veins travel between the muscles and travel 90% of the blood and superficial under the skin on the muscles and carry 10% of the blood. Perforating veins establish a connection between the deep and superficial veins at various levels in the leg and provide transition to superficial balls.
Perforating veins also contain valves, which only allow passage from the superficial vein to the deep.
Figure 1.2. Localization of perforating veins
Perforating veins in the knee region are the first perforating vein at the ankle level. Others are located 7-9cm above this and 10-12cm above. Other perforating vessels are located at the knee level and in the thigh area.
Various problems such as discoloration and ulcers, especially in the ankle area, develop due to the transition from deep to superficial veins due to the deterioration of these valves due to various reasons.
Perforating vein failure was also detected in approximately 55-60% of patients who developed venous ulcers due to chronic venous insufficiency.
Figure 3. Skin changes in chronic venous insufficiency.
What are the causes of this perforating vein deficiency?
In general, determination of perforating vein diameter of 3.5mm and above is found as a finding in favor of failure. It also gives information about the severity of imaging and duration of the flow back in the dopp.
Figure 1.2. Enlarged perforating vein and leak in Doppler
What applications are available for treatment in perforating vein insufficiency?
The treatment methods to be applied for the perforating vein differ. Although these methods are often the same as those applied to other varicose therapies, their application techniques vary widely.
Connecting the perforating vein with an endoscope. It is one of the most frequently used methods in the past. It is not preferred much because it requires special tools.
ANTALYA VARICOSE VEINS/Dr.İlhan Gölbaşı