Venae perforantes: a clinical review.
BACKGROUND
Although many articles on perforating veins have been published, much knowledge about these veins is lacking.


OBJECTIVE
In this review relevant facts about the clinical importance of perforating veins in venous disease are described.


METHODS
A literature search on English, French and German articles has been performed using literature databases like Medline, Embase and Cochrane.


RESULTS
Selection criteria are described.


CONCLUSIONS
A few conclusions are drawn: incompetent perforating veins can be of haemodynamic importance, especially in venous ulceration and (recurrent) varicose veins. The current definition of incompetent perforating veins is reflux more than 0,5 seconds (detected by Duplex ultra-sonography). Good anatomical and clinical classifications are published and should be integrated in the CEAP classification. Based on the clinical classification treatment options are described for the different types of incompetent perforating veins. Two different treatment modalities for incompetent perforating veins are surgery (SEPS) and sclerotherapy. SEPS seems to be of benefit in patients with venous ulceration and advanced CVI. Sclero-therapy (especially ultra sound guided sclerotherapy) is promising and worth further evaluation.
van Neer
Pierre Antonius Franciscus Alexius
PA
Laurentius Hospital, Roermond University Hospital, Maastricht Erasmus Medical Center, Rotterdam, the Netherlands. dermatologie1@lzr.nl
Veraart
Joep Cristianus Jacobus Maria
JC
Neumann
Hendrik Arent Martino
HA
D006439:Hemodynamics; D006801:Humans; D015911:Sclerotherapy; D014647:Varicose Ulcer / Q000503:physiopathology; D014680:Veins / Q000033:anatomy & histology / Q000503:physiopathology*; D014689:Venous Insufficiency / Q000503:physiopathology / Q000628:therapy*