Abstract
Valve dysfunction alters this situation. If perforator vein valves are dysfunctional, some deep vein volume at high pressure is transmitted to the superficial
system with each calf contraction. This may have at least three major effects: (1)
effective ejection fraction for venous return from the deep system is reduced;
(2) excessive pressures in the superficial system may further compromise valve competency; and (3) the sustained increase in venous volume effects microcirculation
resulting in endothelial cell changes and an increase in outward flux of fluids and
materials from capillaries and venules. Resultant changes in capillary hemodynamics, nutritional blood flow, and interstitium content and volume then follow.