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Distribution and prevalence of reflux in the superficial and deep venous system in the general population--results from the Bonn Vein Study, Germany.
J Vasc Surg 2008; 48(3):680-7JV

Abstract

OBJECTIVE

Venous diseases are among the most frequent diseases in the general population of industrialized countries. The aim of this article is to investigate the population-based prevalence of pathologic reflux in superficial and deep leg veins, taking into account factors as gender, age, and clinical classification of venous disease.

METHODS

In a population-based cross-sectional study, 3072 subjects aged 18 to 79 years (1350 male, 1722 female, response 59%) were enrolled from October 2000 through November 2001. A standardized interview was conducted to document phlebological history and clinical examinations including duplex sonography of selected superficial and deep leg veins. Pathological reflux was defined as being >500 ms. All participants where classified according to the CEAP classification.

RESULTS

Using the highest clinical stage per participant, 9.6% where classified C0, 59.0% C1, 14.3% C2, 13.5% C3, 2.9% C4, and 0.7% C5-C6. A pathological reflux (>500 ms) was found in 35.3% (95% confidence interval [CI] 33.6-37.1) of subjects with 21.0% (95% CI 19.5-22.5) showing reflux in at least one superficial vein and 20.0% (95% CI 18.6-21.5) showing reflux in at least one deep vein. We observed significantly higher reflux prevalence for the superficial veins in women while for the deep veins reflux prevalence were significantly higher in men. Prevalence of reflux in the superficial veins markedly increases with age. In the deep venous system, no clear changes in reflux prevalence with age can be observed. For superficial veins, reflux prevalence is markedly higher with higher C-stages. For the deep veins, the proportion of refluxes is relatively constant in stages C0-C3 with a distinct increase of prevalence from stage C4 onward.

CONCLUSION

Our results show a high prevalence of reflux both for the superficial and the deep venous system. Reflux prevalence is associated with gender, age, and the clinical stage as measured by the CEAP classification. Further longitudinal studies are needed to clarify the relevance of pathological reflux in subjects with otherwise healthy veins.

Authors+Show Affiliations

Department of Surgery, Paula Stradina University Hospital of Riga, Riga, Latvia.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

18586443

Citation

Maurins, Uldis, et al. "Distribution and Prevalence of Reflux in the Superficial and Deep Venous System in the General Population--results From the Bonn Vein Study, Germany." Journal of Vascular Surgery, vol. 48, no. 3, 2008, pp. 680-7.
Maurins U, Hoffmann BH, Lösch C, et al. Distribution and prevalence of reflux in the superficial and deep venous system in the general population--results from the Bonn Vein Study, Germany. J Vasc Surg. 2008;48(3):680-7.
Maurins, U., Hoffmann, B. H., Lösch, C., Jöckel, K. H., Rabe, E., & Pannier, F. (2008). Distribution and prevalence of reflux in the superficial and deep venous system in the general population--results from the Bonn Vein Study, Germany. Journal of Vascular Surgery, 48(3), pp. 680-7. doi:10.1016/j.jvs.2008.04.029.
Maurins U, et al. Distribution and Prevalence of Reflux in the Superficial and Deep Venous System in the General Population--results From the Bonn Vein Study, Germany. J Vasc Surg. 2008;48(3):680-7. PubMed PMID: 18586443.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distribution and prevalence of reflux in the superficial and deep venous system in the general population--results from the Bonn Vein Study, Germany. AU - Maurins,Uldis, AU - Hoffmann,Barbara H, AU - Lösch,Christian, AU - Jöckel,Karl-Heinz, AU - Rabe,Eberhard, AU - Pannier,Felicitas, Y1 - 2008/06/30/ PY - 2007/11/27/received PY - 2008/04/02/revised PY - 2008/04/10/accepted PY - 2008/7/1/pubmed PY - 2008/9/16/medline PY - 2008/7/1/entrez SP - 680 EP - 7 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 48 IS - 3 N2 - OBJECTIVE: Venous diseases are among the most frequent diseases in the general population of industrialized countries. The aim of this article is to investigate the population-based prevalence of pathologic reflux in superficial and deep leg veins, taking into account factors as gender, age, and clinical classification of venous disease. METHODS: In a population-based cross-sectional study, 3072 subjects aged 18 to 79 years (1350 male, 1722 female, response 59%) were enrolled from October 2000 through November 2001. A standardized interview was conducted to document phlebological history and clinical examinations including duplex sonography of selected superficial and deep leg veins. Pathological reflux was defined as being >500 ms. All participants where classified according to the CEAP classification. RESULTS: Using the highest clinical stage per participant, 9.6% where classified C0, 59.0% C1, 14.3% C2, 13.5% C3, 2.9% C4, and 0.7% C5-C6. A pathological reflux (>500 ms) was found in 35.3% (95% confidence interval [CI] 33.6-37.1) of subjects with 21.0% (95% CI 19.5-22.5) showing reflux in at least one superficial vein and 20.0% (95% CI 18.6-21.5) showing reflux in at least one deep vein. We observed significantly higher reflux prevalence for the superficial veins in women while for the deep veins reflux prevalence were significantly higher in men. Prevalence of reflux in the superficial veins markedly increases with age. In the deep venous system, no clear changes in reflux prevalence with age can be observed. For superficial veins, reflux prevalence is markedly higher with higher C-stages. For the deep veins, the proportion of refluxes is relatively constant in stages C0-C3 with a distinct increase of prevalence from stage C4 onward. CONCLUSION: Our results show a high prevalence of reflux both for the superficial and the deep venous system. Reflux prevalence is associated with gender, age, and the clinical stage as measured by the CEAP classification. Further longitudinal studies are needed to clarify the relevance of pathological reflux in subjects with otherwise healthy veins. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/18586443/Distribution_and_prevalence_of_reflux_in_the_superficial_and_deep_venous_system_in_the_general_population__results_from_the_Bonn_Vein_Study_Germany_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(08)00630-7 DB - PRIME DP - Unbound Medicine ER -