International Session: Stents, Perforators, and Vein Care
Next-Generation Stent Design
A keynote lecture argued that current venous stents suffer from low porosity, which
slows endothelial coverage and limits inflow from side branches, and from rigidity that
causes straightening and stenosis at overlap sites. The proposed solution is a segmented,
length-adjustable, high-porosity stent that conforms to the vein rather than forcing the
vein to conform to the stent.
Debating Incompetent Perforator Veins
Three speakers debated managing incompetent perforators in venous ulcer patients:
targeting them directly with thermal ablation or glue, treating them as a byproduct of
ultrasound-guided foam sclerotherapy around the ulcer, or leaving them until superficial
reflux and deep obstruction are corrected. Panelists generally agreed perforator treatment
should come last, reserved for ulcers that fail to heal after axial reflux correction.
Practice-Changing Publications
Additional talks found that delaying tributary treatment after saphenous ablation avoids
unnecessary procedures in roughly half of patients, that foam sclerotherapy causes more
intense pigmentation than combined laser-sclerotherapy for reticular veins, and that
obesity reduces but does not eliminate symptomatic benefit from standard chronic venous
disease treatment.
