Schedule a Consultation
(716) 839-3638
Cockett's I, II and III perforator veins and perforator vein reflux - cross border healthcare in the U.S. for Canadian patients at the Vein Treatment Center in Buffalo Niagara
Monday, September 2, 2013




image of Cockett's I perforator veins, Cockett's II perforator veins, Cockett's III perforator veins


Diagram of Cockett's Types




So what does the "perforator" terminology mean? It means that the vessel "perforates" the aponeurosis of the muscle, giving it the name.  The aponeurosis is fascial tissue that invests or envelops muscle groups and binds these muscle groups to other muscle groups or to bone. The perforator veins 'pop through' the muscle fascia to connect with the superficial veins. The normal flow pattern is for the superficial veins to drain into the deep veins of the legs through these perforator veins. However, when the perforator veins leak, i.e. perforator venous reflux disease, bllod in the deep veins leaks through the perforator veins into the superficial veins of the legs, causing venous hypertension.


The gaiter areas are the areas where skin changes and venous stasis ulcers are most likely to occur - these areas are where the most prominent perforator veins are likely to be found. perforator vein incompetence in these gaiter areas have been shown to increase ambulatory venous pressures above 100 mm Hg (venous hypertension), a phenomenon which has also been referred to "ankle blow-out" syndrome in the gaiter areas. The combination of incompetent perforator veins and resultant venous hypertension over time causes damage to capillaries in the skin and nd subcutaneous capillaries, allowing protein rich fluid and red blood cells to escape into the subcutaneous tissue around the ankle. The effect is that the subcutaneous tissue becomes fibrotic and skin pigmentation results from hemosiderin deposition. 


For the treatment of perforator veins reflux with EVLT, VNUS Closure or ClariVein, contact Hratch Karamanoukian, MD FACS at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York or call 716-839-3638.


Hratch Karamanoukian, MD FACS is triple board certified in general surgery, thoracic surgery (cardiovascular surgery), and phlebology (diseases of the venous system and lymphatic system).   and  are partners with




Tags :
© 2012 Vein Guide, Inc. All rights reserved.