Journal «Angiology and Vascular Surgery» • 

2001 • VOLUME 7 • №1

THE FIRST EXPERIENCE WITH ENDOSCOPIO SUBFASCIAL CLIPPING OF INEOI PETENT PERFORATING VEINS OF THE LOWER LIMBS

D.Ye. Yepifanov, A.V. Kuznetsov, A.V. Belykh, Yu.V. Maximov
Department of Vascular Surgery, Republican Cardiology Centre Syktyvkar,
Komi, Russia

The paper reports the clinical observations and results of successful surgical treatment of 16 patients with valvular incon fence of perforating veins of the lower limbs and trophic disorc of the leg. The patients were operated on using endoscopic clipping of incompetent perforating veins. Between 1999 to 2000, 16 patients (13 women and 3 men) undea went clipping of incompetent perforating veins at the Departmeni of Cardiovascular Surgery. The mean patients' age was 44 years. Nine patients presented with trophic lesions in the form of persistent non-healing sores and seven patients had skin pigmentation and induration of subcutaneous fat. The size of trophic ulcers varied from 0.7 to 3 cm. Three patients had undergone previous phlebectomy for varicosity. Eight patients were operated on using one-stage phlebectomy of varicose subcutaneous veins of the lower limbs. Of these, two patients were operated on by extravasal coareel ion of femoral vein valves. The operation was performed undder regional anesthesia (spinal, peridural). During operation, endc scopic surgical appliances and endoscopic instruments manufactm by the Olympus Company were employed. Intraoperatively, one patient developed hemorrhage consequent on perforating vein injury, which required Linton's operation using a classical access. No complications were recorded in the postoperative period. The sutures were removed on the 7th-8th day following operation. The healing of trophic ulcers wbs observed on the 9th-T8th day after operation. The hospital stay amounted to 14 days. After operatin all the patients were followed up for 6 to 12 months. No trophic ulcer recurrences were recorded. All the patients noted an improvement of well-being, disappearance of paresthesias, attenuation of edema and sensation of heaviness in the lower limbs.

KEY WORDS: endoscopic clipping of perforating veins, chronic veins.

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