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BACKGROUND Although exact understanding of the pathophysiology of incompetent perforating veins (IPVs) of the foot is lacking and their presence controversial, this entity appears to be real and clinically useful.

OBJECTIVE To explore this clinical phenomenon and improve treatments of varicose vein of the foot.

METHODS & MATERIALS Nine patients, aged 36–79 years, and a total of ten IPVs of the foot underwent office ligation over a period of twenty months. Diagnostic criteria included clinical examination, a Doppler Ultrasound (DU) evidence of reflux over 0.5 seconds, and further confirmation of the reflux and localization by Duplex scanning (DS).

RESULTS All patients showed improvement in appearance and presenting symptoms. Eight patients described the results as good, and one stated moderate improvement. One patient required a second surgery to ligate the offending perforating vein. No wound related complication occurred, but one patient experienced persistent numbness and another had persistent edema of the foot.

CONCLUSIONS A set of diagnostic criteria including clinical examination, Doppler Ultrasound evidence of reflux over 0.5 seconds, and further confirmation of the reflux and localization by Duplex scanning appears to be reliable and clinically useful.