[Insufficiency of crural perforators: myths, dogma and reality]

The author evaluates critically ideas on the importance of insufficient crural perforators in the pathogenesis of primary varicosities, incl. states with chronic venous insufficiency. Based on published facts assessed by phlebodynamometry, assessment of the blood flow, duplex sonography and plethysmography, the author provides evidence that impaired venous circulation is due to reflux in the insufficient saphenous vein. Conversely insufficient crural perforators do not cause venous disorders but are due to reflux in the insufficient saphenous vein.