Pl. Allan et al., Patterns of reflux and severity of varicose veins in the general population - Edinburgh Vein Study, EUR J VAS E, 20(5), 2000, pp. 470-477
Citations number
22
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Objectives: several studies have used duplex ultrasound to assess valvular
incompetence in symptomatic patients. This cross-sectional survey was perfo
rmed to determine, for the first time in a general population sample, the r
elationship between trunk varices and the presence of reflux in lower limb
venous segments.
Materials and Methods: 1238 subjects (554 male, 684 female), aged 18-64 yea
rs, were randomly selected. The presence and severity of any trunk varices
was assessed and classified into Grades 1-3; hyphenweb and reticular varice
s were noted. The presence or absence of reflux greater than or equal to 0.
5 s in five deep and three superficial venous segments in each leg was asse
ssed using duplex ultrasound.
Results: the prevalence of reflux increased in both superficial and deer se
gments with more severe grades of trunk varices (p less than or equal to0.0
1), except the upper SFV in women. Fifteen per cent of females showed reflu
x confined to the superficial system, compared with 9% of males (p less tha
n or equal to0.001); 22% of males showed deep reflux, compared with 11% of
females (p less than or equal to 0.001). 71% of men and 48% of women with G
rade 2-3 trunk varices had mixed deep and superficial reflux. Above-knee po
pliteal segments had a higher prevalence of reflux than lower SFV segments
in all groups. There was no consistent relationship between the presence of
hyphenweb or reticular varices and deep or superficial reflux.
Conclusion: segmental venous reflux can be detected in the deep and superfi
cial leg veins of subjects without trunk varices, but superficial and mixed
reflux are increasingly found in subjects with more severe varices.