Perforator Marking Prior to Surgery


Some varicose vein operations may include surgery on incompetent (faulty) perforating veins. This study is performed prior to surgery to assist the surgeon specifically target incompetent perforating veins, thereby reducing the length and number of incisions required. The study is usually performed on the day of surgery or the day before surgery.

Not everyone who has varicose veins will have perforating veins that require treatment. This test is usually requested by the surgeon when incompetent perforating veins have been identified on a previous ultrasound scan and the surgeon feels that some of these perforating veins require treatment.


One or both legs will need to be exposed from groin to ankle, depending on the extent of surgery that is planned. Clothing covering the legs should be either loose or easily removed.

Explanation of study technique: Jelly is placed on the skin of the leg being scanned and an ultrasound probe is placed over the areas of concern. Images of the veins are produced on screen and the direction of blood flow is determined (see the section on “how ultrasound works” for more details). When an incompetent perforating vein is identified the overlaying skin is marked with a felt-tipped pen. The surgeon uses these marks as guide in planning the incisions. It is important that these marks are not washed off, or rubbed off, prior to surgery – doing the study close to the time of surgery helps, but care is still required to preserve the markings!


Typically 30 – 40 minutes per leg, depending on the complexity of the varicose veins and the number of perforating veins marked.

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