Pattern and Prevalence of Venous Reflux in Patients with Lower Extremity Chronic Venous Insufficiency

ABSTRACT

Abstract Pattern and Prevalence of Venous Reflux in Patients with Lower Extremity Chronic Venous Insufficiency Burapa        Kanchanabat                 MD Yuttapong Wongmahisorn              MD Waigoon     Stapanavatr                  MD Pong           Kanchanasuthiruk         MD Anan           Manomaiphiboon                     MD, MSc (Clinical Epidemiology) Department of surgery, BMA Medical College and Vajira Hospital. Objective: To study the pattern and prevalence of deep and superficial venous reflux in chronic venous insufficiency (CVI) patients. Study design: Prospective descriptive study. Subjects: A total of 30 CVI patients (40 legs) with Clinical Etiological Anatomical Pathological (CEAP) classification of ≥ C4 who attended the vascular clinic at BMA Medical College and Vajira Hospital between October 2006 and December 2007 were prospectively enrolled. Methods: The history and physical examination of the patients were recorded. Reflux of common femoral, superficial femoral, popliteal and greater saphenous veins were examined in all patients with the duplex doppler ultrasonography. The lesser saphenous veins were examined in 17 patients (22 legs). The reflux time more than 500 milliseconds were used for reflux diagnosis. Main outcome measures: Pattern and prevalence of venous reflux in lower extremity CVI patients. Results: In 30 CVI patients, there were 15 male and 15 female patients, with the mean age of 56.2 ± 12.5 years. In 30 legs (22 patients), which had not been operated for greater saphenous venous stripping, the most common pattern of reflux was combined superficial and deep vein reflux which were found in 80.0%. The isolated superficial and deep vein reflux were 6.7% and 10.0% respectively. Overall, deep and superficial vein reflux were found in 90.0% and 86.7% respectively. In 10 legs (8 patients) that had previous greater saphenous venous stripping, the incidence of deep vein reflux was 80.0%. The lesser saphenous veins were examined in 22 legs (17 patients), and reflux was found in 13 legs (59.0%). Conclusion: In patients who had not had greater saphenous venous stripping, the incidence of deep venous reflux was 90.0% and the incidence of superficial venous reflux was 86.7%. The common pattern was combined superficial and deep vein reflux, which were found in 90.0%. The isolated reflux was uncommon and found in only 6.7% and 10.0% for superficial vein and deep vein respectively. Vajira Med J 2008 ; 52 119 - 128