Chronic Venous Insufficiency: Surgical Therapy

Priority is given to conservative therapy (see Further Therapy below).

In severe cases, the following operations are indicated:

• Open ligation of insufficient perforating veins (connections between the superficial and deep venous systems) (Wilkinson, 1986).
• Endoscopic ligation of insufficient (“deficient”) perforating veins; these veins connect the superficial and deep leg veins (Pierik, 1997)
• If necessary, for therapy-resistant ulcers (ulcers):
  • Surgical vein reconstruction or vein valve grafting (Iafrati et al., 1997; Jamieson et al., 1997) or fascial surgery (Hach).