[The incompetent perforators in the development of varicose veins]

Abstract

Aim: Does it make sense to dissect any incompetent perforator which is found with the color duplex sonography during the preoperative mapping of varicose veins?

Patients and methods: 221 patients with recurrent varicose veins were examined by color duplex sonography for new transfascial insufficiencies.

Results: Among 371 transfascial insufficiencies there were 61 (16.4%) incompetent perforators. 31 isolated perforators (25 (9.4%) of 266 legs isolated perforators of the thigh,6 (2.3%) isolated perforators of the calf) were exclusively responsible for the recurrence of varicose veins. 13 incompetent perforators of the calf were associated with additional transfascial insufficiencies,as well as superficial and in 3 cases even deep varicose veins, resulting at an advanced clinical stage (CEAP-classification C3-CS).

Conclusion: The dissection of the thigh perforators and the rare isolated perforators of the calf may help to protect from possible and early recurrence.