Images in vascular medicine:Perforator vein incompetence in a 10-year-old male
Abstract
Images in vascular medicine Perforator vein incompetence in a 10-year-old male SAGE Publications, Inc. 201110.1177/1358863X11405396 © The Author(s) The Author(s) Yung-WeiChi UC Davis Medical Center, Sacramento, CA, USA, ywchi@yahoo.com Victor SLucus Ochsner Heart and Vascular Institute, New Orleans, LA, USA Corresponding author: Yung-Wei Chi UC Davis Medical Center Sacramento, CA 95817 USA Email: ywchi@yahoo.com Panel A Panel B Panel C A 10-year-old male presented with right calf painful swell- ing 2 years after he accidentally hit his right calf against a wrought-iron bed railing. A localized bruise and edema pro- gressed in size along with symptoms over the past 2 years. At presentation, the swelling measured 51 mm (Panel A). Certain movements, such as dorsiflexion and running, exacerbated his symptoms. Vascular surgery and interventional radiology at an outside facility diagnosed cavernous venous malformation and possible arteriov- enous malformation, based on magnetic resonance venog- raphy and computed tomographic venogram. Venous color duplex at our institution showed right distal calf perforator (Cockett’s perforator) incompetency with varicosities (Panel B). A subsequent venogram showed prominent vari- cose veins without vascular malformation (Panel C). The patient underwent successful ultrasound-guided endov- enous laser ablation (VenaCure EVLT™; AngioDynamics, Latham, NY, USA) of the incompetent perforator;