Perforans Varicosis: Treatment of the Incompetent Perforating Vein Is Important

Background. Varicose veins that arise from incompetent perforating veins are called perforans‐varicosis. Objective. This case report illustrates the relationship between incompetent perforating veins and varicosis. Methods. An incompetent perforating vein, proximal of a varicose vein located at the dorsal side of the thigh, was treated by means of ultrasound‐guided sclerotherapy with 1% polidocanol foam. The varicose vein was not treated. Results. After 1 week, the varicose vein and the incompetent perforating vein showed no reflux. The varicose vein was practically invisible. The residual vein was treated with sclerotherapy. After 6 weeks the varicose vein was still invisible. Conclusion. This proximal incompetent perforating vein was important for the development and maintenance of the varicose vein. Treatment of this incompetent perforating vein resulted in complete disappearance of the reflux in the varicose vein. In this case ultrasound‐guided sclerotherapy was succesful in treating the incompetent perforating vein. More studies are needed to investigate the long‐term effect of ultrasound‐guided sclerotherapy as treatment of perforans‐varicosis.