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Duplex mapping of 2036 primary varicose veins.
J Vasc Surg. 2009 Mar; 49(3):681-9.JV

Abstract

OBJECTIVE

To produce a comprehensive anatomical and hemodynamic ultrasound scan mapping of the whole limb in patients with primary varicose veins (VVs).

DESIGN

An analysis of venous duplex scans performed on patients referred for treatment of primary VVs.

METHODS

A total of 2036 limbs were evaluated, looking for the origin of VVs in the saphenous systems and in the perforating vein (PV) systems, as well as for the presence of non-saphenous reflux.

RESULTS

The sapheno-femoral junction (SFJ) of the great saphenous vein (GSV) was involved in 1330 limbs (65.3%). We have noted that finding reflux in the groin does not imply that it originates at that point necessarily, as reflux from the pelvis or abdominal wall can also cause primary VVs (SFJ reflux, 41.9% and competent SFJ with reflux from proximal veins, 35.4%). We also noted that analyzing only the presence of reflux in the SFJ of the GSV would miss 10.9% of limbs of reflux in the SFJ of the anterior accessory GSV. In 237 limbs (11.6%), reflux was observed in the popliteal fossa. In the PV system, we distinguished those PVs with retrograde flow that acted as an origin of the VVs, and other PVs that acted as re-entry points. Based on this difference, the location identified as the most frequent origin of VVs in the PV system was the thigh, specifically in the group of PVs of the medial thigh of the femoral canal, with 85 PVs with a total of 238 incompetent PVs identified. Pure non-saphenous reflux was observed in 162 limbs (8%).

CONCLUSION

The assumption that the origin of VVs would be exclusively in the sapheno-femoral or sapheno-popliteal junction, is a mistaken attitude and a comprehensive duplex scan mapping is recommended.

Authors+Show Affiliations

Department of Angiology and Vascular/Endovascular Surgery, Hospital San Pedro, Logroño, Spain. mike170gagi@openbankmail.comNo 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

19268773

Citation

García-Gimeno, Miguel, et al. "Duplex Mapping of 2036 Primary Varicose Veins." Journal of Vascular Surgery, vol. 49, no. 3, 2009, pp. 681-9.
García-Gimeno M, Rodríguez-Camarero S, Tagarro-Villalba S, et al. Duplex mapping of 2036 primary varicose veins. J Vasc Surg. 2009;49(3):681-9.
García-Gimeno, M., Rodríguez-Camarero, S., Tagarro-Villalba, S., Ramalle-Gomara, E., González-González, E., Arranz, M. A., García, D. L., & Puerta, C. V. (2009). Duplex mapping of 2036 primary varicose veins. Journal of Vascular Surgery, 49(3), 681-9. https://doi.org/10.1016/j.jvs.2008.09.062
García-Gimeno M, et al. Duplex Mapping of 2036 Primary Varicose Veins. J Vasc Surg. 2009;49(3):681-9. PubMed PMID: 19268773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Duplex mapping of 2036 primary varicose veins. AU - García-Gimeno,Miguel, AU - Rodríguez-Camarero,Santiago, AU - Tagarro-Villalba,Salvador, AU - Ramalle-Gomara,Enrique, AU - González-González,Emma, AU - Arranz,Miguel Angel González, AU - García,Diego López, AU - Puerta,Carlos Vaquero, PY - 2007/08/16/received PY - 2008/09/26/revised PY - 2008/09/29/accepted PY - 2009/3/10/entrez PY - 2009/3/10/pubmed PY - 2009/3/20/medline SP - 681 EP - 9 JF - Journal of vascular surgery JO - J Vasc Surg VL - 49 IS - 3 N2 - OBJECTIVE: To produce a comprehensive anatomical and hemodynamic ultrasound scan mapping of the whole limb in patients with primary varicose veins (VVs). DESIGN: An analysis of venous duplex scans performed on patients referred for treatment of primary VVs. METHODS: A total of 2036 limbs were evaluated, looking for the origin of VVs in the saphenous systems and in the perforating vein (PV) systems, as well as for the presence of non-saphenous reflux. RESULTS: The sapheno-femoral junction (SFJ) of the great saphenous vein (GSV) was involved in 1330 limbs (65.3%). We have noted that finding reflux in the groin does not imply that it originates at that point necessarily, as reflux from the pelvis or abdominal wall can also cause primary VVs (SFJ reflux, 41.9% and competent SFJ with reflux from proximal veins, 35.4%). We also noted that analyzing only the presence of reflux in the SFJ of the GSV would miss 10.9% of limbs of reflux in the SFJ of the anterior accessory GSV. In 237 limbs (11.6%), reflux was observed in the popliteal fossa. In the PV system, we distinguished those PVs with retrograde flow that acted as an origin of the VVs, and other PVs that acted as re-entry points. Based on this difference, the location identified as the most frequent origin of VVs in the PV system was the thigh, specifically in the group of PVs of the medial thigh of the femoral canal, with 85 PVs with a total of 238 incompetent PVs identified. Pure non-saphenous reflux was observed in 162 limbs (8%). CONCLUSION: The assumption that the origin of VVs would be exclusively in the sapheno-femoral or sapheno-popliteal junction, is a mistaken attitude and a comprehensive duplex scan mapping is recommended. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/19268773/Duplex_mapping_of_2036_primary_varicose_veins_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(08)01668-6 DB - PRIME DP - Unbound Medicine ER -