Jan Sloves: Medial Thigh Perforators – The Veins We Keep Missing
Jan Sloves, President and Consultant at Vascular Imaging Professionals LLC, shared a post on LinkedIn about a recent article by Gabriela Hnatkova et al., published in JVS – VL:
“Medial Thigh Perforators: The Veins We Keep Missing
A new JVSVL paper mapped 371 medial thigh perforators in 306 limbs – and it quietly challenges how we decide which perforators matter in chronic venous disease.
The headline finding: diameter alone is not the decision‑maker.
Multiple perforators with a lumen less than 3.5 mm still showed reflux more than 0.5 s and acted as independent sources of superficial reflux, contributing to progression and recurrence.
That sits uneasily next to guideline language that still leans on greater than or equal to 3.5 mm at the fascia plus reflux as the classic definition of ‘insufficient.’
The authors also demonstrate how densely clustered these perforators are along the medial thigh, how often they connect to non‑GSV suprafascial veins, and how foam sclerotherapy echocontrast suddenly reveals a subfascial network that routine duplex simply does not show.
By the time we label a case ‘recurrent varicosities,’ these perforators have often been part of the story all along.
For anyone scanning or treating CVD, the practical messages are simple: deliberately search the medial thigh in defined zones, not just ‘around’ the GSV; document perforator connections and reflux pattern, not only diameter; expect that standard mapping underestimates the true communication network sustaining reflux.
I’m curious how this aligns with your practice: are sub‑3.5 mm perforators with clear reflux already on your treatment radar, or do size cut‑offs still dominate your decision‑making?
Subscribe to the only newsletter built for vascular pros.”
Title: The anatomical conditions of the venous perforators of the medial side of the thigh in progressive chronic venous disease
Auhtors: Gabriela Hnatkova, Lukas Hnatek, David Kachlik
Other articles featuring Jan Sloves on Hemostasis Today.
-
Jul 13, 2026, 17:39Pascal Boulanger: Send a Postcard to Your Lab Staff From ISTH 2026
-
Jul 13, 2026, 17:21Stefano Navarro: Presenting Our Recently Published Article at ISTH 2026
-
Jul 13, 2026, 17:12Santagata Davide: A Great Session and an Incredible Opportunity to Present Our Research at ISTH 2026
-
Jul 13, 2026, 16:26Real-World Data Across Time Reveal Important Advances in Hemophilia Treatment – ATHN
-
Jul 13, 2026, 16:19Mary Cushman: Celebrating Our Incredible ISTH Council Members in Paris
-
Jul 13, 2026, 16:17Wolfgang Miesbach: Gene Therapy Shows Promising Early Results in Adolescents With Hemophilia B at ISTH 2026
-
Jul 13, 2026, 16:06Dino Mehic: Honored to Receive the ISTH Early Career Top Reviewer Awards
-
Jul 13, 2026, 16:01Advancing DIC Diagnosis in Cirrhosis Through Disease-Specific Risk Stratification – JTH
-
Jul 13, 2026, 15:52Joshua Muia: Presenting Our Research on ADAMTS13/VWF Dysregulation in Sepsis at ISTH 2026