Endovenous microwave closure of perforating veins in the treatment of chronic venous insufficiency of the lower extremities

Objective To evaluate the clinical therapeutic effects of endovenous microwave closure of perforating veins by percutaneous puncture in the treatment of chronic venous insufficiency,complicated with incompetence of the calf perforating veins of the lower extremities. Methods All the 213 patients (278 limbs) with superficial varicose veins of the lower extremities complicated with incompetence of the calf perforating veins underwent high ligation of the great saphenous vein,with simultaneous ultrasound-guiding microwave coagulation and closure of the superficial varicose veins and perforating veins of the lower extremities by percutaneous puncture. Venous ulcer of the lower extremities were treated at the same time by integrated traditional and western medicine. Results In 213 patients (278 limbs),632 perforating veins were detected preoperatively,and 629 were closed by microwave treatment. One week to three months after operation,624 perforating veins were proved to be closed or nonvisualized by transonogram or phlebography,only 5 were not closed completely. The healing time of leg ulcers in 109 limbs (C6) were 9～101 days [mean (31.25±8.28) d],the conditions and symptoms of skin malnutrition in 169 limbs (C4,C5) were improved in different degrees. A total of 201 patients were followed up from 3 to 42 months,and 6 cases(5.50%) had recurrence of ulcers. There was no statistical difference of plasma D-dimer before and after operation in all patients. Conclusions Endovenous microwave closure technique of perforating veins by percutaneous puncture is a novel treatment for chronic venous insufficiency complicated with incompetence of the calf perforating veins; it has been proved to have good curative effect,with increased safety,easy recovery and minimal invasiveness. It is especially suitable for patients with leg ulcers,and with no obvious postoperative complications.