The treatment of venous insufficiency requires the detection and eradication of superficial veins that are the location of venous reflux. Venous reflux is present in varicose veins, and may be observed in the great saphenous vein or the short saphenous vein.
Perforator veins pass through the deep fascia to connect the superficial venous system to the deep system. Healthy perforator veins allow the superficial veins to drain into the deep veins; the valves in the perforator veins prevent blood from flowing backward out of the deep veins into the superficial veins.
When perforator veins become incompetent, the valves fail to function properly, allowing a back flow of blood from the higher-pressure deep vein into the superficial veins. This may cause a blow out in the superficial system and lead to the development of varicose veins, skin changes around the ankle or leg ulcers.
P’s in the figure below are the potential sites of some but not all perforators in the lower extremity.
Prior to treatment with the ClosureRFS device, the patient’s leg is scanned to verify the location, size and shape of the perforator to be treated.
The design of the ClosureRFS device allows for treatment of incompetent perforators under ultrasound guidance. Treatment of incompetent perforators can be either the primary procedure or an adjunctive procedure to treatment of superficial venous reflux with the VNUS ClosureFAST or ClosurePLUS catheter.