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Comparative evaluation of duplex-derived parameters in patients with chronic venous insufficiency: correlation with clinical manifestations.
J Am Coll Surg. 2002 Dec; 195(6):822-30.JA

Abstract

BACKGROUND

Quantification of venous reflux is still a matter of debate. Our goal was to compare the duplex-derived parameters between patients with early and advanced chronic venous insufficiency (CVI), and to determine indicative parameters reflecting the progression of CVI.

STUDY DESIGN

A total of 1,132 limbs in 914 patients with primary valvular incompetence were included. Clinical manifestations were categorized according to the CEAP (clinical, etiologic, anatomic, and pathophysiologic) classification, and the patients were divided into two groups: group I (those with relatively early CVI, C(1-3)E(P),A(S,D,P),P(R)) and group II (those with advanced CVI, C(4-6)E(P),A(S,D,P),P(R)). The distribution of venous insufficiency was determined, and the parameters assessed were the duration of reflux (s), the peak reflux velocity (cm/s), and the flow at peak reflux (mL/s).

RESULTS

There was no notable difference in overall superficial venous reflux between the groups, and the frequency of isolated deep and perforator incompetence did not differ between the groups. The duration of reflux did not improve the discrimination power between the groups. In contrast, the peak reflux velocity had significant discrimination power at the saphenofemoral junction (p < 0.0001), the saphenopopliteal junction (p = 0.0002), in the greater saphenous vein (p < 0.0001), in the superficial femoral vein (p = 0.0041), and in the popliteal vein (p = 0.003). The peak reflux flow was significantly higher in group II at the saphenofemoral junction (p < 0.0001), the saphenopopliteal junction (p = 0.0029), in the greater saphenous vein (p < 0.0001), in the common femoral vein (p = 0.006), in the superficial femoral vein (p = 0.0005), and in the popliteal vein (p = 0.0003).

CONCLUSIONS

Superficial venous insufficiency might play a major role in the development of advanced CVI. The peak reflux velocity and peak reflux volume improve discrimination power between early-stage and advanced CVI.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12495315

Citation

Yamaki, Takashi, et al. "Comparative Evaluation of Duplex-derived Parameters in Patients With Chronic Venous Insufficiency: Correlation With Clinical Manifestations." Journal of the American College of Surgeons, vol. 195, no. 6, 2002, pp. 822-30.
Yamaki T, Nozaki M, Fujiwara O, et al. Comparative evaluation of duplex-derived parameters in patients with chronic venous insufficiency: correlation with clinical manifestations. J Am Coll Surg. 2002;195(6):822-30.
Yamaki, T., Nozaki, M., Fujiwara, O., & Yoshida, E. (2002). Comparative evaluation of duplex-derived parameters in patients with chronic venous insufficiency: correlation with clinical manifestations. Journal of the American College of Surgeons, 195(6), 822-30.
Yamaki T, et al. Comparative Evaluation of Duplex-derived Parameters in Patients With Chronic Venous Insufficiency: Correlation With Clinical Manifestations. J Am Coll Surg. 2002;195(6):822-30. PubMed PMID: 12495315.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative evaluation of duplex-derived parameters in patients with chronic venous insufficiency: correlation with clinical manifestations. AU - Yamaki,Takashi, AU - Nozaki,Motohiro, AU - Fujiwara,Osamu, AU - Yoshida,Eika, PY - 2002/12/24/pubmed PY - 2003/1/30/medline PY - 2002/12/24/entrez SP - 822 EP - 30 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 195 IS - 6 N2 - BACKGROUND: Quantification of venous reflux is still a matter of debate. Our goal was to compare the duplex-derived parameters between patients with early and advanced chronic venous insufficiency (CVI), and to determine indicative parameters reflecting the progression of CVI. STUDY DESIGN: A total of 1,132 limbs in 914 patients with primary valvular incompetence were included. Clinical manifestations were categorized according to the CEAP (clinical, etiologic, anatomic, and pathophysiologic) classification, and the patients were divided into two groups: group I (those with relatively early CVI, C(1-3)E(P),A(S,D,P),P(R)) and group II (those with advanced CVI, C(4-6)E(P),A(S,D,P),P(R)). The distribution of venous insufficiency was determined, and the parameters assessed were the duration of reflux (s), the peak reflux velocity (cm/s), and the flow at peak reflux (mL/s). RESULTS: There was no notable difference in overall superficial venous reflux between the groups, and the frequency of isolated deep and perforator incompetence did not differ between the groups. The duration of reflux did not improve the discrimination power between the groups. In contrast, the peak reflux velocity had significant discrimination power at the saphenofemoral junction (p < 0.0001), the saphenopopliteal junction (p = 0.0002), in the greater saphenous vein (p < 0.0001), in the superficial femoral vein (p = 0.0041), and in the popliteal vein (p = 0.003). The peak reflux flow was significantly higher in group II at the saphenofemoral junction (p < 0.0001), the saphenopopliteal junction (p = 0.0029), in the greater saphenous vein (p < 0.0001), in the common femoral vein (p = 0.006), in the superficial femoral vein (p = 0.0005), and in the popliteal vein (p = 0.0003). CONCLUSIONS: Superficial venous insufficiency might play a major role in the development of advanced CVI. The peak reflux velocity and peak reflux volume improve discrimination power between early-stage and advanced CVI. SN - 1072-7515 UR - https://www.unboundmedicine.com/medline/citation/12495315/Comparative_evaluation_of_duplex_derived_parameters_in_patients_with_chronic_venous_insufficiency:_correlation_with_clinical_manifestations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(02)01670-8 DB - PRIME DP - Unbound Medicine ER -