The value of ultrasound in the assessment of incompetent perforating veins

Abstract

To determine the value of ultrasound in identifying significant perforator disease we assessed 121 perforators in 90 legs of 61 consecutive patients referred for assessment of varicose veins over a 6 month period. Perforators greater than 4mm in diameter demonstrated reflux in approximately 60% of cases, perforators 3-4 mm in diameter demonstrated reflux in approximately 45% and perforators less than 3 mm in diameter demonstrated reflux in approximately 25% of cases. From correlation with previous published data we recommend that all perforators greater than 4 mm in diameter be considered incompetent regardless of whether reflux is demonstrated.

Incompetent perforating veins of the foot

“…The anatomy of perforating veins in the leg, pathophysiology and hemodynamic significance in chronic venous insufficiency have been discussed frequently in the past. [1,2,3,4,5,6,7].…”

Incompetent perforating veins of the foot

“…Diagnostic criteria for the incompetent perforating vein of the leg has also changed frequently as technological advances were made. [8,9,10,11,6]. Duplex scanning has become a dominant diagnostic tool in recent years as D.U.…”

Review of Venous Vascular Ultrasound

“…All these possibilities can be assessed by duplex US [65]. To accurately assess perforator incompetence, note should be taken of the diameter of the perforator and its physical relation with respect to clinical varices as not all incompetent perforators will be judged incompetent by reflux criteria alone [65,77]. The duration of clinically significant reflux determined by Doppler assessment is controversial.…”