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Prevalence and causes of reflux in deep venous system of the leg in patients with insufficiency of superficial veins


Authors: D. Musil 1;  J. Herman 2
Authors‘ workplace: Nestátní interní a cévní ambulance, II. poliklinika, Olomouc 1;  II. chirurgická klinika Lékařské fakulty UP a FN, Olomouc, přednosta prof. MUDr. Miloslav Duda, DrSc. 2
Published in: Vnitř Lék 2006; 52(6): 596-601
Category: Original Contributions

Overview

The aim of the prospective study was to find out the following:
1.What is the prevalence of deep vein reflux of the leg in patients with superficial vein reflux detected by ultrasonography? 2. What are the possible causes of deep vein insufficiency of the leg retrospectively detectable on the basis of targeted medical history? 3. Is the incidence of identified deep vein insufficiency of the leg gender specific?

The sample consisted of 100 legs with superficial vein reflux detected on ultrasonography (C1 – C4 / CEAP) of 79 randomized patients (59 women aged 45 ± 12 years and 20 men aged 52 ± 15 years). We collected the medical history of all patients and examined them for any vascular diseases of the leg. Superficial and deep venous system of the leg was examined by routine duplex ultrasonography with 7.5 a 10 MHz linear probe in B-mode, colour flow mapping and pulse Doppler using Valsalva manoeuvre and manual compression of thigh. During the examination, patients lay both prone and on their back.

Results:
Prevalence of deep vein reflux in patients with superficial vein reflux detected by ultrasonography was 43 %. Prevalence of deep vein reflux in patients only with primary venous insufficiency (i.e. personal medical history without phlebothrombosis of the leg, trauma, surgery or plaster fixation) was 35.4 % in our sample. The possible causes of deep vein reflux in our patients are the following: overweight and obesity (58.6 %), primary valvular insufficiency (35.4 %), secondary valvular insufficiency - post-thrombotic, post-traumatic (34.9 %) and various combinations of these factors. Deep vein insufficiency increased with the BMI. Deep vein reflux was significantly more frequent in men (80 %) as compared with women (54.2 %).

Key words:
venous insufficiency – reflux – deep venous system – superficial venous system – duplex ultrasonography – BMI


Sources

1. Classification and Grading of Chronic Venous Disease in the Lower Limbs: A Consensus Statement. Phlebology 1995;10: 42-45.

2. Evans CJ et al. Prevalence of venous reflux in the general population on duplex scanning: The Edinburgh Vein Study. J Vasc Surg 1998; 28: 767-776.

3. Ioannou CV et al. Patterns of venous reflux in limbs with venous ulcers. Implications for treatment. Int Angol 2003; 22: 182-187.

4. Labropoulos N, Tassiopoulos AK et al. Prevalence of deep venous reflux in patients with primary superficial vein incompetence. J Vasc Surg 2000; 32: 663-668.

5. Musil D, Herman J. Příčina klinických projevů chronické žilní nedostatečnosti u pacientů s nadváhou a obezitou. Vnitř Lék 2005; 51: 523-528.

6. Musil D. Vyšetření ultrazvukem. In: Herman J. et al (eds): Chirurgie varixů dolních končetin. Praha: Grada Publishing 2003, 47-58.

7. Neglen P, Egger JF, Olivier J et al. Haemodynamic and clinical impact of ultrasound-derived venous reflux parameters. J Vacs Surg 2004; 40: 303-310.

8. Přerovský I. Patofyziologie žilní cirkulace. In: Fejfar Z, Přerovský I (eds). Patofyziologie krevního oběhu. Praha: Avicenum 1980, 392-398.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 6

2006 Issue 6

Most read in this issue
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