Association of Venous Volume and Diameter of Incompetent Perforator Veins in the Lower Limb—Implications for Perforator Vein Surgery

To define the association between venous volume as measured with air-plethysmography and the duplex ultrasound measured diameter of incompetent perforator of the lower limb. Thirty-six patients with chronic venous disease were investigated with air-plethysmography and duplex ultrasound. Venous volume and venous filling time was measured. Venous filling index was calculated. The findings were correlated with the diameter of the largest incompetent perforator vein of the lower limb. Twenty-six patients with venous volume in the normal range (80–170ml) had a median perforator diameter of 3.5mm (IQR 3.2–4.3). Ten patients with venous volume above 170ml had median perforator diameter of 5.5mm (IQR 4.6–7.7). (p=0.001, Mann–Whitney). There was a correlation between the venous volume and diameter of the largest incompetent perforator vein. (Pearson correlation factor 0.69, p=0.01). Limb volume correlates to the diameter of the largest incompetent perforator of the calf. Increase in venous limb volume could be partly responsible for an increase in the size of calf perforators thereby promoting incompetence.