Perforator veins connect the deep leg veins to the surface veins. Their purpose is to equalise the pressure between the inside and the surface of the legs. This is when the leg muscles are contracting and relaxing during walking and running. Blood flow within perforators normally goes from the skin surface to the deep veins.
What’s the problem with perforator veins?
In about 20% of people suffering from varicose veins, the perforator veins are also abnormal. That is, they are bigger than normal and blood flows from the deep veins out to the skin surface under pressure. People with more varicose veins, have more abnormal perforators. The pressure caused by abnormal perforators can affect the skin causing thickening, discolouration, eczema and ulceration.
Usually, if a person’s varicose veins have been thoroughly treated, abnormal perforators do not need further treatment and they often return to normal function. Occasionally, perforators remain abnormal, causing varicose veins to return or surrounding skin to deteriorate or form ulcers. These types of perforators need treatment.
What are the treatments?
The good news is that for most people, when the surrounding varicose veins have been treated, abnormal perforators do not need additional treatment.
When perforators are causing serious skin problems, such as ulcers, non-heating vein treatments like VenaSeal, appear to be superior. This is because VenaSeal allows safe treatment all the way to the ankle with a low the risk of nerve damage.
Sometimes, a single or several persistent perforators need further treatment. In this situation, a heating treatment usually performed under local anaesthetic using RFA (radiofrequency ablation) can reliably close the perforator, with a low risk of nerve damage.