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Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein.
J Vasc Surg. 2002 Dec; 36(6):1225-30.JV

Abstract

OBJECTIVE

Interruption of incompetent perforating veins (PVs) is important for varicose vein surgery. The purpose of this study was to evaluate the preoperative and intraoperative diameter-reflux relationship of PVs and to evaluate the accuracy of preoperative duplex scanning in patients with varicose vein.

METHODS

Patients with primary varicose veins were retrospectively investigated. Diameters and reflux of PVs were evaluated before surgery with color flow duplex ultrasound scan (US). During operation, the incompetent PVs were defined as those that showed an outward spurt of blood flow from the stump of the PVs. The sensitivity and specificity of US in the detection of reflux of PVs were calculated. Competent versus incompetent vein diameters were compared with the Student t test and one-way analysis of variance.

RESULTS

Three hundred twenty-four calf PVs were detected in 304 legs of 175 patients with varicose vein. Diameters of competent and incompetent PVs confirmed with intraoperative finding averaged 2.67 +/- 1.10 mm (n = 28) and 3.28 +/- 1.01 mm (n = 58), respectively, at the upper calf (P =.012), 2.85 +/- 0.85 mm (n = 53) and 3.68 +/- 0.94 mm (n = 137), respectively, at the lower calf (p <.001), and 2.67 +/- 0.99 mm (n = 14) and 3.27 +/- 0.66 mm (n = 22), respectively, at the posterior calf (P =.036). The overall sensitivity of detection of reflux with US was 87.7%, and the specificity was 75.3%. Diameters of true-incompetent PVs and false-incompetent PVs were 3.59 +/- 0.94 mm (n = 199) and 3.31 +/- 0.84 mm (n = 24), respectively (P =.157). Diameters of true-competent PVs and false-competent PVs were 2.61 +/- 0.91 mm (n = 73) and 2.89 +/- 0.82 mm (n = 28), respectively (P =.158).

CONCLUSION

Although the diameter of incompetent PVs was larger than that of competent PVs in both US and intraoperative findings, diameter measurement alone can not completely distinguish competent and incompetent PVs. The sensitivity and specificity of reflux obtained with US showed that the accuracy of preoperative duplex scanning to evaluate PV competency was not sufficient.

Authors+Show Affiliations

Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, Japan 431-3192.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12469055

Citation

Yamamoto, Naoto, et al. "Preoperative and Intraoperative Evaluation of Diameter-reflux Relationship of Calf Perforating Veins in Patients With Primary Varicose Vein." Journal of Vascular Surgery, vol. 36, no. 6, 2002, pp. 1225-30.
Yamamoto N, Unno N, Mitsuoka H, et al. Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein. J Vasc Surg. 2002;36(6):1225-30.
Yamamoto, N., Unno, N., Mitsuoka, H., Saito, T., Miki, K., Ishimaru, K., Kaneko, H., & Nakamura, S. (2002). Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein. Journal of Vascular Surgery, 36(6), 1225-30.
Yamamoto N, et al. Preoperative and Intraoperative Evaluation of Diameter-reflux Relationship of Calf Perforating Veins in Patients With Primary Varicose Vein. J Vasc Surg. 2002;36(6):1225-30. PubMed PMID: 12469055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative and intraoperative evaluation of diameter-reflux relationship of calf perforating veins in patients with primary varicose vein. AU - Yamamoto,Naoto, AU - Unno,Naoki, AU - Mitsuoka,Hiroshi, AU - Saito,Takaaki, AU - Miki,Keita, AU - Ishimaru,Kei, AU - Kaneko,Hiroshi, AU - Nakamura,Satoshi, PY - 2002/12/7/pubmed PY - 2003/1/8/medline PY - 2002/12/7/entrez SP - 1225 EP - 30 JF - Journal of vascular surgery JO - J Vasc Surg VL - 36 IS - 6 N2 - OBJECTIVE: Interruption of incompetent perforating veins (PVs) is important for varicose vein surgery. The purpose of this study was to evaluate the preoperative and intraoperative diameter-reflux relationship of PVs and to evaluate the accuracy of preoperative duplex scanning in patients with varicose vein. METHODS: Patients with primary varicose veins were retrospectively investigated. Diameters and reflux of PVs were evaluated before surgery with color flow duplex ultrasound scan (US). During operation, the incompetent PVs were defined as those that showed an outward spurt of blood flow from the stump of the PVs. The sensitivity and specificity of US in the detection of reflux of PVs were calculated. Competent versus incompetent vein diameters were compared with the Student t test and one-way analysis of variance. RESULTS: Three hundred twenty-four calf PVs were detected in 304 legs of 175 patients with varicose vein. Diameters of competent and incompetent PVs confirmed with intraoperative finding averaged 2.67 +/- 1.10 mm (n = 28) and 3.28 +/- 1.01 mm (n = 58), respectively, at the upper calf (P =.012), 2.85 +/- 0.85 mm (n = 53) and 3.68 +/- 0.94 mm (n = 137), respectively, at the lower calf (p <.001), and 2.67 +/- 0.99 mm (n = 14) and 3.27 +/- 0.66 mm (n = 22), respectively, at the posterior calf (P =.036). The overall sensitivity of detection of reflux with US was 87.7%, and the specificity was 75.3%. Diameters of true-incompetent PVs and false-incompetent PVs were 3.59 +/- 0.94 mm (n = 199) and 3.31 +/- 0.84 mm (n = 24), respectively (P =.157). Diameters of true-competent PVs and false-competent PVs were 2.61 +/- 0.91 mm (n = 73) and 2.89 +/- 0.82 mm (n = 28), respectively (P =.158). CONCLUSION: Although the diameter of incompetent PVs was larger than that of competent PVs in both US and intraoperative findings, diameter measurement alone can not completely distinguish competent and incompetent PVs. The sensitivity and specificity of reflux obtained with US showed that the accuracy of preoperative duplex scanning to evaluate PV competency was not sufficient. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/12469055/Preoperative_and_intraoperative_evaluation_of_diameter_reflux_relationship_of_calf_perforating_veins_in_patients_with_primary_varicose_vein_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741521402003191 DB - PRIME DP - Unbound Medicine ER -