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

Czech version

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

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