Incompetent perforating veins are associated with recurrent varicose veins

Aims: we suspected incompetent perforating veins of having a role in the de velopment of recurrent varicose veins in some patients. The aim was to look for an association between perforators and recurrent varicose veins. Methods: a consecutive group of patients presenting with varicose veins wer e examined using colour duplex ultrasonography by an experienced vascular t echnologist. Pathological perforating veins were defined as those exhibitin g bidirectional flow and a diameter of 4 mm or greater at the fascia. Results: between September 1998 and July 1999, 204 patients were examined. Primary varicose veins were found in 198 legs (135 patients) and recurrent varicose veins in 91 legs (69 patients). In patients with primary varicose veins, 88 (44%) had incompetent perforators compared to 57 (63%) of those w ith recurrent varicose veins (Chi-squared, p <0.005). Also, far recurrent v aricose veins, the percentage of patients with any given number of incompet ent perforators was higher than for primary varicose veins. Overall, there was a higher number of incompetent perforators in those with recurrent vein s compared to primary veins and this difference was significant at 95% conf idence interval. Conclusion: patients with recurrent varicose veins have both a higher preva lence and a gr eater number of incompetent perforating veins than patients with primary varicose veins.