High intensity focused ultrasound in treating incompetent perforator veins

Background To describe and analyze technical and clinical outcomes of High Intensity Focused Ultrasound (HIFU) in treating perforator veins (PVs) pathological incompetence. Material and Methods Patients with isolated PVs incompetence determining varicose veins underwent focal HIFU of the PV. The primary endpoint was the rate of PV shrinkage or closure after 1 year. Results from December 2021 to January 2025, 467 legs in 416 patients were treated with HIFU. Among these, 25 pathological isolated PVs in 25 patients were treated and included in the analysis. No new PV pathological reflux was seen in 90.8%, 92.8%, 90%, and 100% of patients at 1 week, 3 months, 6 months, and 12 months from HIFU, respectively. Conclusion HIFU could be a valid alternative in treating PVs. Due to the pivotal nature of these data, further studies are needed to strengthen the results and compare HIFU with other methods.