Combined treatment with endovenous laser ablation and compression therapy of incompetent perforating veins for treatment of recalcitrant XXXX .

@entity1 @entity1066 @entity2117 @entity4165 @entity3179 @entity17622 @entity1150 @entity337 @entity158 @entity291
OBJECTIVE: @entity1 with healed @entity3179 often experience recurrence of @entity1066 , despite the use of long-term compression therapy. This study examines the effect of closing incompetent perforating veins (IPVs) on @entity1066 recurrence rates in @entity1 with progressive @entity4165 and impending @entity1066 . METHODS: @entity1 with nonhealing @entity3179 of >2 months' duration underwent duplex ultrasound to assess their lower extremity venous system for @entity337 of superficial, perforating, and deep veins. Endovenous laser ablation (EVLA) of perforating veins was performed on @entity1 with @entity17622 6 disease with @entity2117 , @entity4165 , and/or progressive @entity158 . A minimum of 2 months of compressive therapy was attempted before endovenous ablation of IPVs. Demographic data, risk factors, @entity17622 classification, procedural details, and postoperative status were all recorded. RESULTS: Forty ulcers with 46 associated IPVs were treated with EVLA in 36 @entity1 with @entity17622 6 recalcitrant @entity3179 . Treated incompetent perforator veins were located in the medial ankle (85.7%), @entity291 (10.7%), and lateral ankle (3.5%). Endovenous laser ablation was successful in 76% (35/46) with the first laser treatment of incompetent perforator veins and 15.2% (7/46) additional ablation procedures were performed. Of the 46 treated IPVs, 42 (91.3%) were occluded on the duplex examination at 12 months. The average energy administrated per perforating vein treated was 162 joule. Two @entity1 reported localized paresthesia, which subsided spontaneously, but no @entity1150 or skin burn was observed. CONCLUSION: Especially in the case of liposclerotic or ulcerated skin in the affected region, PAP of IPVs is highly effective, safe, and appears to be feasible. @entity1 with @entity3179 appear to benefit from EVLA of incompetent perforators in order to reduce the risk of @entity1066 recurrence.
