PURPOSE: The contribution of perforating vein incompetence to the hemodynamic derangement in the chronic venous disease (CVD) remains a topic of debate. This study was designed to define the characteristics of IPV according to CEAP classification with development of CVD. METHOD: From March 1999, to August 2001, 145 patients were treated for CVD in our hospital. Of these, 15 patients with CEAP class 4, 5, 6 (Group I) and 130 patients with class 2 (Group II). Medial side of calf was assessed in the sitting position for looking IPVs by duplex scan. The number, location, and diameter at the fascia level of IPVs were determined. The characteristics of IPVs between two group were compared. Airplethysmogram (APG) was checked pre and postoperatively in 18 patients with class 2 without any procedure to IPVs. RESULT: 17 IPVs were found in 11/15 (73%) patients in group I, and 36 IPVs were found in 29/145 (20%) in group II. The mean number of IPVs in each limb of group I and II was 1.54, 1.09 (P>0.05) and the mean diameter was 0.52 cm, 0.38 cm (P=0.001). The 96% (51/56) of IPVs were found in lower half of the calf. All hemodynamic parameter of APG was improved statistically significantly after operation without ligation of IPVs in class 2 patients. CONCLUSION: With advancing of CVD (class 4, 5, 6), IPVs was found more and larger. This suggest significant hemodynamic role of IPVs in progression of CVD. So careful attention should be payed to IPVs in treatment of CVD. But it was doubted benefit of direct treatment of IPVs in class 2.
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