Professional paper

Subfascial Endoscopic Perforating Vein Surgery (Seps): The Technique and Our Views

Björn Dario Franjić
Ivo Lovričević
Tomislav Kuna
Zvonimir Puljiz
Narcis Hudorović
Drago De Syo
Aljoša Matejčić
Miroslav Bekavac-Bećlin

Abstract

Chronic venous insufficiency is a major health and socioeconomic issue throughout the world. Some 2%-5% of the adult population suffers from chronic venous insufficiency, while about 1% of the European population has chronic leg ulceration. The role of retrograde blood flow through incompetent perforating veins has an important role in the development of chronic venous insufficiency. Duplex ultrasound imaging is the preferred diagnostic tool, which is used to confirm the presence of bidirectional flow through the perforators adjacent to the areas of lipodermatosclerosis, healed ulcers and open ulcerations, i.e. in patients with chronic venous insufficiency CEAP class 4, 5 and 6. Subfascial endoscopic perforating vein surgery (SEPS) is a minimally invasive surgical procedure, which is the treatment of choice in these patients. The endoscope and surgical instruments are introduced through skin incisions that are distant from the areas of skin changes. The perforating veins are excellently visualized, while clipping and dividing the perforators interrupt retrograde blood flow. In patients with insufficiency of the superficial venous system, ligation and stripping of the superficial veins are usually performed at the same time. The lesser saphenous vein can be occluded with SEPS itself. The healing time with SEPS is substantially decreased when compared with conventional treatment and carries low complication and recurrence rates. However, SEPS should be offered to selected patients, i.e. to those with chronic venous insufficiency CEAP class 4, 5 and 6.

Keywords

Vascular surgical procedures, methods; Vascular surgical procedures, utilization; Peripheral vascular diseases, surgery; Croatia

Hrčak ID:

14696

URI

https://hrcak.srce.hr/14696

Publication date:

1.12.2003.

Article data in other languages: croatian

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