[Significance of venous endoscopy in the exploration and the treatment of venous insufficiency of the legs].
From a pathophysiological standpoint, the analysis of superficial valve lesions provides arguments in favour of the existence of early reflux and widens the role of valves beyond a simple antireflux system. All valves are not the same. Study of their topography in relation to collaterals and perforators enables definition of their role and of the origin of preferential hemodynamic circuits. Therapeutically, the first indications of venous endoscopy were in the visual control of deep venous thrombectomy, then in the preparation of saphenous bypasses in situ. It enables confirmation of the devalvulation of a segment of long saphenous and obstruction of afferent collaterals without an incision, by the endoscopic insertion of "micro-umbrellas". In addition, endoscopy can be used to identify incompetent deep valves suitable for valvuloplasty. In the superficial venous system, endoscopy offers a third dimension in the identification of varicosities in complex zones, such as the popliteal fossa. Furthermore, the development of a system for the endoscopic obliteration of superficial veins (ligatures, laser, umbrellas, chemical glue) could simplify the treatment of varicose veins.
Blanchemaison
P
P
Service de Médecine interne et de Pathologie vasculaire, Hôpital Tenon, Paris.
D004724:Endoscopy; D006801:Humans; D014648:Varicose Veins / Q000503:physiopathology; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000628:therapy*
Intérêt de l'endoscopie veineuse dans l'exploration et le traitement de l'insuffisance veineuse des membres inférieurs.