Perforator Treatments

Perforator veins serve as connections between the two networks of veins in the legs: the superficial venous system and the deep venous system. Perforator veins allow the blood near the skin (our superficial veins) to drain into our deep veins, which then leads the blood back to the Heart.

All our veins, including perforator veins have one-way valves designed to keep the blood flowing in one direction: toward the heart. When those valves no longer function properly and reflux occurs, the buildup of blood and pressure can cause perforator veins and associated superficial veins to become incompetent, or to backflow. Perforator veins in the lower leg and ankle are particularly vulnerable to distention and incompetence, and the resultant circulatory problems create an increased likelihood of edema, skin discoloration, dermatitis and skin ulcers in the immediate area.

Although the majority of varicose veins, and venous insufficiency develops from the saphenous veins, perforator veins are a common contributor to wounds, swelling, skin changes, and large varicose veins. They may also be the cause of continued symptoms even after saphenous vein ablations have been completed. Thus, we take a comprehensive approach and continue to follow up with each patient after treatment has been completed. If you have symptoms of burning, fatigue, edema, heaviness, itching, skin changes, ulcerations, or visible varicose veins in your legs, or have been diagnosed with venous insufficiency you may need an ablation of refluxing perforator veins performed.

Our office uses the ClosureRFS stylet to treat perforator veins using radio-frequency ablation. It is the only intravascular ablation device specifically intended for the treatment of incompetent perforator and tributary veins. We perform this minimally invasive procedure in our office. There is no need for general anesthesia, and no down-time or recovery period. Using ultrasound guidance, a fine needle is passed into the perforating vein through the skin. The area is locally anesthetized (numbed). The radio-frequency current heats the inside of the perforator vein causing it to shrink down and discontinue the reflux, or backward flow between the deep veins and varicose veins. The whole process takes approximately 20-30 minutes per perforating vein. Patients return to activities the same day, and most report minimal pain, and little or no scarring after the procedure.

1. Oblonsky E. Incompetent Perforator. Premier Vein Center Arlington Heights Illinois. Accessed October 17, 2017.

2. Covidien ClosureRFS™ Stylet | Venefit™ Procedure by Covidien. Accessed October 17, 2017.