Ligation of the perforator veins can be reserved for patients with persistent incompetent perforator vessels after superficial stripping surgery of great saphenous vein (a minority of patients about 28%). Our data support the hypothesis that Knee level stripping of the great saphenous vein alone has an effect on incompetent leg perforators in most patients with symptomatic CVI due to superficial and perforator vein incompetence, without deep venous insufficiency and can be treated with superficial stripping procedure alone.