Reviewed by Brian R. Robinson, MD
Perforator veins are connecting veins. They connect the superficial veins (those just below the surface of the skin) to the deep veins (those within the muscles). They are called perforator veins because they pass through or "perforate" the fascia (a connective tissue membrane) overlying the muscle. When perforator veins are said to be “incompetent,” this means that they do not function properly, and so are unable to perform their work – pumping blood between superficial and deep veins – as they should. This condition involves the veins of the legs.
Normally, blood flows through perforator veins from the superficial system to the deep system, and is prevented from backflow by a series of valves that close prevent the blood from flowing in the direction from which it came.
However, in the case of incompetent perforator veins, the valves do not function properly, meaning they are damaged or stretched, and blood flows back out to the superficial veins, causing increased pressure under the skin. This process leads to damage in the form of pooled blood just under the skin, which can lead to a host of problems. Incompetent perforator veins occur in the legs and are one of a range of venous insufficiencies and conditions common in this area of the body.