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Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation.

Abstract

BACKGROUND

the variability of venous reflux patterns complicate the management of venous disease. Our study investigates specific variations in venous anatomy and patterns of reflux in varying clinical situations.

METHODS

prospective analysis of 464 legs in 355 patients was performed by complete duplex venous mapping of both primary and recurrent varicose veins. Hand Held Doppler (HHD) and Duplex Ultrasonography (Duplex US) observations in the popliteal fossa were compared in a subgroup of 89 patients with primary varicose veins. Distribution of venous system disease was correlated with clinical severity in a subgroup of 117 affected legs which was representative of the overall study group.

RESULTS

sapheno-femoral junction (SFJ) incompetence predominated in both primary and recurrent varicose veins. Only 21% of primary legs and 25% of recurrent legs had sapheno-popliteal junction (SPJ) incompetence. SPJ incompetence was present in only 42% of cases where reflux in the popliteal region on HHD had been demonstrated. A proportion of both primary and recurrent varicose veins had evidence of deep venous incompetence (DVI). Sixty-four percent of primary leg ulcer patients had superficial incompetence alone. In patients with recurrent varicosities and ulceration, 57% had SPJ incompetence, 64% multiple sites and 50% DVI.

CONCLUSION

the complex variations of varicose vein anatomy and functional pathology in the lower limb are currently best assessed by complete whole-leg venous duplex mapping.

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  • Authors+Show Affiliations

    ,

    Department of General Surgery, Raigmore Hospital, Inverness, Scotland.

    ,

    Source

    MeSH

    Adult
    Aged
    Chronic Disease
    Female
    Femoral Vein
    Humans
    Leg
    Male
    Middle Aged
    Popliteal Vein
    Postoperative Complications
    Recurrence
    Saphenous Vein
    Ultrasonography, Doppler, Duplex
    Varicose Ulcer
    Varicose Veins
    Vascular Surgical Procedures
    Venous Insufficiency

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    12623340

    Citation

    Wong, J K F., et al. "Whole-leg Duplex Mapping for Varicose Veins: Observations On Patterns of Reflux in Recurrent and Primary Legs, With Clinical Correlation." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 25, no. 3, 2003, pp. 267-75.
    Wong JK, Duncan JL, Nichols DM. Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation. Eur J Vasc Endovasc Surg. 2003;25(3):267-75.
    Wong, J. K., Duncan, J. L., & Nichols, D. M. (2003). Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 25(3), pp. 267-75.
    Wong JK, Duncan JL, Nichols DM. Whole-leg Duplex Mapping for Varicose Veins: Observations On Patterns of Reflux in Recurrent and Primary Legs, With Clinical Correlation. Eur J Vasc Endovasc Surg. 2003;25(3):267-75. PubMed PMID: 12623340.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation. AU - Wong,J K F, AU - Duncan,J L, AU - Nichols,D M, PY - 2003/3/8/pubmed PY - 2003/4/1/medline PY - 2003/3/8/entrez SP - 267 EP - 75 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 25 IS - 3 N2 - BACKGROUND: the variability of venous reflux patterns complicate the management of venous disease. Our study investigates specific variations in venous anatomy and patterns of reflux in varying clinical situations. METHODS: prospective analysis of 464 legs in 355 patients was performed by complete duplex venous mapping of both primary and recurrent varicose veins. Hand Held Doppler (HHD) and Duplex Ultrasonography (Duplex US) observations in the popliteal fossa were compared in a subgroup of 89 patients with primary varicose veins. Distribution of venous system disease was correlated with clinical severity in a subgroup of 117 affected legs which was representative of the overall study group. RESULTS: sapheno-femoral junction (SFJ) incompetence predominated in both primary and recurrent varicose veins. Only 21% of primary legs and 25% of recurrent legs had sapheno-popliteal junction (SPJ) incompetence. SPJ incompetence was present in only 42% of cases where reflux in the popliteal region on HHD had been demonstrated. A proportion of both primary and recurrent varicose veins had evidence of deep venous incompetence (DVI). Sixty-four percent of primary leg ulcer patients had superficial incompetence alone. In patients with recurrent varicosities and ulceration, 57% had SPJ incompetence, 64% multiple sites and 50% DVI. CONCLUSION: the complex variations of varicose vein anatomy and functional pathology in the lower limb are currently best assessed by complete whole-leg venous duplex mapping. SN - 1078-5884 UR - https://www.unboundmedicine.com/medline/citation/12623340/Whole_leg_duplex_mapping_for_varicose_veins:_observations_on_patterns_of_reflux_in_recurrent_and_primary_legs_with_clinical_correlation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078588402006159 DB - PRIME DP - Unbound Medicine ER -