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Sapheno-femoral junction reflux in patients with a normal saphenous trunk.
Eur J Vasc Endovasc Surg. 2004 Dec; 28(6):595-9.EJ

Abstract

OBJECTIVE

To determine the patterns and clinical importance of saphenofemoral junction (SFJ) reflux in patients with chronic venous disease (CVD) and a normal great saphenous vein (GSV) trunk.

METHODS

Fifteen hundred consecutive patients were examined using duplex ultrasound (DU) in three centres. Patients with reflux involving the SFJ and/or its tributaries only were included and its prevalence and patterns were studied. Patients with GSV trunk reflux or in any other veins were excluded. The SFJ diameter was categorised as normal, dilated or varicose. The results of surgery were evaluated by DU in 42 patients 1 year after the procedure.

RESULTS

SFJ area incompetence with a competent GSV trunk occurred in 8.8% of limbs. It was significantly more common in CEAP class 2, 13.6% compared to class 3, 8.2% (p=0.03), class 1, 2.7%, class 4, 4.4% and classes 5 and 6 together, 1.5% (p<0.001 for all). The SFJ had a normal diameter in 21%, dilated in 62% and varicose in 17%. Reflux was seen in 39% of limbs with a normal SFJ diameter, in 85% of those with a dilated SFJ and in all varicose SFJs. Of the 42 operated limbs, 27 had ligation and division of the SFJ and tributary phlebectomies. Fifteen had tributary phlebectomies only, leaving the SFJ intact. At one-year follow-up, SFJ area reflux was found in six limbs (14.3%), involving the SFJ alone in 1, a main tributary in 1 and 4 small tributaries. No reflux was found in the GSV trunk. All but two of the 42 patients were satisfied with the results.

CONCLUSIONS

SFJ reflux with tributary involvement and sparing of the GSV trunk occurs in 8.8% of CVD patients. Such reflux is found in the entire spectrum of CVD, but it is more common in class 2. Local surgery with or without SFJ ligation has very good results at 1 year. DU scanning prior to treatment is important in all patients so that the intact GSV can be spared.

Authors+Show Affiliations

Loyola University Medical Center, Maywood, IL 60653, USA. nlabrop@lumc.eduNo 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

15531193

Citation

Labropoulos, N, et al. "Sapheno-femoral Junction Reflux in Patients With a Normal Saphenous Trunk." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 28, no. 6, 2004, pp. 595-9.
Labropoulos N, Leon L, Engelhorn CA, et al. Sapheno-femoral junction reflux in patients with a normal saphenous trunk. Eur J Vasc Endovasc Surg. 2004;28(6):595-9.
Labropoulos, N., Leon, L., Engelhorn, C. A., Amaral, S. I., Rodriguez, H., Kang, S. S., Mansour, A. M., & Littooy, F. N. (2004). Sapheno-femoral junction reflux in patients with a normal saphenous trunk. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 28(6), 595-9.
Labropoulos N, et al. Sapheno-femoral Junction Reflux in Patients With a Normal Saphenous Trunk. Eur J Vasc Endovasc Surg. 2004;28(6):595-9. PubMed PMID: 15531193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sapheno-femoral junction reflux in patients with a normal saphenous trunk. AU - Labropoulos,N, AU - Leon,L, AU - Engelhorn,C A, AU - Amaral,S I, AU - Rodriguez,H, AU - Kang,S S, AU - Mansour,A M, AU - Littooy,F N, PY - 2004/07/27/accepted PY - 2004/11/9/pubmed PY - 2004/12/22/medline PY - 2004/11/9/entrez SP - 595 EP - 9 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 - 28 IS - 6 N2 - OBJECTIVE: To determine the patterns and clinical importance of saphenofemoral junction (SFJ) reflux in patients with chronic venous disease (CVD) and a normal great saphenous vein (GSV) trunk. METHODS: Fifteen hundred consecutive patients were examined using duplex ultrasound (DU) in three centres. Patients with reflux involving the SFJ and/or its tributaries only were included and its prevalence and patterns were studied. Patients with GSV trunk reflux or in any other veins were excluded. The SFJ diameter was categorised as normal, dilated or varicose. The results of surgery were evaluated by DU in 42 patients 1 year after the procedure. RESULTS: SFJ area incompetence with a competent GSV trunk occurred in 8.8% of limbs. It was significantly more common in CEAP class 2, 13.6% compared to class 3, 8.2% (p=0.03), class 1, 2.7%, class 4, 4.4% and classes 5 and 6 together, 1.5% (p<0.001 for all). The SFJ had a normal diameter in 21%, dilated in 62% and varicose in 17%. Reflux was seen in 39% of limbs with a normal SFJ diameter, in 85% of those with a dilated SFJ and in all varicose SFJs. Of the 42 operated limbs, 27 had ligation and division of the SFJ and tributary phlebectomies. Fifteen had tributary phlebectomies only, leaving the SFJ intact. At one-year follow-up, SFJ area reflux was found in six limbs (14.3%), involving the SFJ alone in 1, a main tributary in 1 and 4 small tributaries. No reflux was found in the GSV trunk. All but two of the 42 patients were satisfied with the results. CONCLUSIONS: SFJ reflux with tributary involvement and sparing of the GSV trunk occurs in 8.8% of CVD patients. Such reflux is found in the entire spectrum of CVD, but it is more common in class 2. Local surgery with or without SFJ ligation has very good results at 1 year. DU scanning prior to treatment is important in all patients so that the intact GSV can be spared. SN - 1078-5884 UR - https://www.unboundmedicine.com/medline/citation/15531193/Sapheno_femoral_junction_reflux_in_patients_with_a_normal_saphenous_trunk_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(04)00357-0 DB - PRIME DP - Unbound Medicine ER -