Background. The purpose of this study was to identify the anatomical l
ocation of the venous disease in C.V.I. patients presented with venous
ulcers in addition to discussing the management, Design. Retrospectiv
e study, at King Khalid University Hospital. Methods. Between January
1991 to January 1991, 90 patients (63 females, 21 males) with CVI were
evaluated. The evaluation included history, clinical examination, bid
irectional ultrasound continuous wave Doppler, Duplex, ambulatory veno
us pressure (AVP), ascending and descending venography. Results. Forty
eight (48) patients (57 limbs) had Stage III with venous ulcers. Out
of these 48 patients, fifteen (15) showed deep venous system involveme
nt with deep vein thrombosis (DVT). Thirty three (33) patients had ven
ous reflux in the superficial or deep systems without occlusion. Out o
f these 33 patients, 24 patients had superficial system reflux, while
the remaining 9 patients revealed deep system reflux with a competent
superficial system. Conclusions. Superficial venous incompetence plays
a major role in venous ulcer formation and that location and type of
venous disease should be thoroughly investigated as surgical excision
of the superficial system leads to a long standing recurrence free per
iod.