PERFORATOR VEINS INCOMPETENCE
Perforator veins traverse the deep fascia of the leg while forming communication channels between the superficial and deep venous systems. Perforator veins connect the superficial to the deep veins. Direct perforator veins are the classical perforators that connect superficial to deep veins while indirect perforators are more variable in their location and connect superficial veins to muscular veins.
Recurrent lower limb venous insufficiency is often a challenge in clinical practice and is most commonly due to incompetent perforators. Many of these patients do not have adequate symptom relief with compression and require some form of treatment for incompetent perforator interruption.
Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized.
Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention.