Objective: This study was undertaken to investigate the role of incompetence of the calf perforating veins in the clinical manifestations of chronic venous insufficiency (CVI) in the lower extremities. Methods: 106 patients with 126 limbs of CVI were examined. Perforator function of the calf were detected by ascending venography. And also

the clinical manifestations of CVI were classified in class by the standard of CEAP classification (the clinical

etiologic

anatomic and pathophysiologic classification). Kendall’s rank correlation analysis was applied among the numbers

diameters of incompetent perforating veins (IPVs)

and the clinical class of CVI. Results: 402 IPVs were identified in 126 limbs

307 IPVs (76.37%) were located in the medial calf

and another 95 IPVs (23.63%) were found in the posterior

anterolateral of the calf.The numbers

diameters of the medial calf IPVs shown positive correlation with the clinical class of CVI. Conclusions: The skin changes of CVI in the lower extremities are mainly relevant to the prevelence of the IPVs in the lower medial calf. The treatment of the IPVs in the medial calf may take some advantages to improve the clinical manifestations

especially skin changes.