ORIGINAL ARTICLE   

Italian Journal of Vascular and Endovascular Surgery 2019 March;26(1):33-8

DOI: 10.23736/S1824-4777.18.01356-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparison of duplex-derived parameters in patients with chronic venous insufficiency with special reference to early symptoms

Masakazu OCHI ¹ ✉, Takashi YAMAKI ², Atsumori HAMAHATA ³, Hisato KONOEDA ², Atsuyoshi OSADA ², Yuki HASEGAWA ², Hiroyuki SAKURAI ²

¹ Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan; ² Department of Plastic and Reconstructive Surgery, Tokyo Women’s Medical University, Tokyo, Japan; ³ Division of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan

BACKGROUND: This study aimed to compare the duplex-derived parameters of reflux between patients with early and advanced chronic venous insufficiency (CVI) and to identify the severity parameters especially in patients with early CVI.
METHODS: Duplex-derived parameters assessed 2343 limbs with SVI categorized into three groups using the CEAP classification at the saphenofemoral junction (SFJ), at the saphenopopliteal junction (SPJ), in the great saphenous vein (GSV), in the perforator veins (PV), and in the deep veins (DV).
RESULTS: There were 247 limbs with mild, 1487 with moderate, and 609 with severe, CVI. The gender distribution showed a significant difference between mild and severe CVI, and moderate and severe CVI. The vein diameter and peak reflux velocity (PRV) at the SFJ and in the GSV significantly increased with progression of the clinical class. Similarly, in the DV, the vein diameter, PRV, and flow at peak reflux (FPR) significantly increased. The proportion of superficial combined with PV insufficiency significantly increased with increasing severity. Similarly, there were significant differences in the proportion of superficial and deep venous insufficiency between mild CVI and moderate CVI, moderate CVI and severe CVI, and mild CVI and severe CVI. Additionally, patients with severe CVI ad a significantly higher proportion of superficial and perforator venous insufficiency combined with deep venous insufficiency than those with moderate CVI.
CONCLUSIONS: Vein diameter, PRV, and FPR were significantly lower in patients with C1, and the proportion of PV and/or DV insufficiency increased with increasing severity.

KEY WORDS: Varicose veins - Venous insufficiency - Varicose ulcer - Duplex Doppler ultrasonography