[The role of perforated veins of the inside thigh in varicose recurrence]

The hunterian and juxtahunterian perforators, which communicate with the deep system on the inner thigh, either with the trunk of the long saphenous vein, single or bifurcated, or with one or several separate trunks, correspond to three schematic anatomical types. They play a major part in the post-surgical relapse of varicose veins, as the author's statistics show. Indeed, out of 157 post-surgical varicose relapses, clinical examination and phlebography have proved that perforator incontinency on the inner thigh contributes to the process in 40 p. cent of the cases, with the exception of 10 p. cent of the cases; normally it is associated with a redeveloped long sapheno-femoral junction, as well as with incontinence of the short sapheno-femoral junction which also relapses eventually. In approximately two out of three cases, sclerosant treatment is enough, but when these perforators are very large they must be operated, following minute examination using a good phlebographical technique.