Treatment of chronic venous insufficiency requires understanding of the hemodynamics of perforating veins. Color Doppler analysis is the best modality to understand the hemodynamics of perforators. Perforating veins were categorized as competent or incompetent depending on the duration of reflux. Perforating veins in which duration of reflux was more than 0.5 seconds were categorized as incompetent perforating veins and perforating veins with reflux less than 0.5 seconds were categorized as competent perforating veins. The average diameter of incompetent perforators was increasing with increasing severity of disease. The number of incompetent perforator per limb also increased with worsening of disease severity and it was significantly higher in CEAP classes 4–6 compared to CEAP classes from 1 to 3 (p<0.05). The average diameter of incompetent perforator in the present study was 3.8mm.
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