Blood-flow in incompetent perforating veins.

A new pulsed multichannel ultrasonic Doppler instrument was used to determine the relative blood-flow in the perforating veins of 16 patients with symptoms attributable to their leg venous systems. 9 patients had leg ulceration and 7 did not. 8 (89%) of the ulcer patients had sustained blood-flow from the deep to the superficial veins ("reverse") during calf muscle contraction, compared to 1 (14%) of the group without leg ulcers. This evidence supports the theory that postphlebitic leg ulceration is the result of retrograde flow of blood in incompetent calf perforating veins during walking.