LIGHT-REFLECTION RHEOGRAPHY AND CLINICAL COURSE OF PATIENTS WITH ADVANCED VENOUS DISEASE BEFORE AND AFTER ENDOSCOPIC SUBFASCIAL DIVISION OFPERFORATING VEINS

BACKGROUND. Endoscopic subfascial division Of perforating veins (ESDP) has been shown to cause fewer surgical complications than classic tec hniques. OBJECTIVE. TO evaluate the efficiacy of ESDP based on patient s' symptoms, rheographic data, and ulcer healing. METHODS. Thirty-two subsequent patients underwent 40 ESDP procedures. Fifteen limbs presen ted with a postthrombotic syndrome (PTS), and 16 cases had an active v enous ulcer. Data were recorded before and 2 months after ESDP. Stripp ing or high ligation procedures had been previously performed. RESULTS . The symptoms of pain and edema improved in 80% (PTS) and 74% (venous ulcer) of patients. Only one case did not show improvement of either pain or edema. Fifty-eight percent of patients showed hemodynamic impr ovement by light reflection rheography (LRR), while 32% did not change and 10% of patients had a worsened LRR after ESDP. The LRR refilling times increased by a median factor of 1.69, reaching at least 20 secon ds in nine of 40 limbs. Venous ulcers that had been active for a media n of 12 years (range, 0.5-21) healed in nine of 16 cases within 14-50 days (median, 21 days). CONCLUSION. ESDP reduces disease-related sympt oms, improves hemodynamics in almost 60%, and facilitates healing of l ong lasting venous ulcers. (C) 1998 by the American Society for Dermat ologic Surgery, Inc.