Contributions to the Diagnosis of Chronic Venous Insufficiency of the Perforating Veins

A perforating vein can become incompetent due to hemodynamic or morphologic causes. Until recently all perforating veins with a diameter exceeding 3 mm at ultrasound exam were considered incontinent(1). Since introduction of duplex doppler and color doppler investigations this hypothesis was temperated because the dilatation of one or more perforating veins was usually observed in chronic venous insufficiency of the superficial veins, allowing the retrograde blood draining flow from the incontinent superficial veins to the deep venous system in standing position. These perforating veins substitute the normal function of the incompetent sapheno-femoral junction. In order to evaluate the incompetence of the perforating veins it is necessary to emphasize the valvular reflux from the deep venous system to a superficial vein(2, 3).