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Deep venous thrombosis and superficial venous reflux
M H Meissner1, M T Caps, B K Zierler
1Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA. meissner@u.washington.edu
Journal of Vascular Surgery
|July 6, 2000
Summary
Superficial venous thrombosis often leads to reflux in the greater saphenous vein (GSV) after deep venous thrombosis (DVT). However, a significant portion of this reflux develops independently of superficial thrombosis.
Area of Science:
- Vascular Surgery
- Venous Thromboembolism Research
- Ultrasound Diagnostics
Background:
- Superficial venous reflux is a key factor in post-thrombotic skin changes.
- The origins of superficial venous reflux following deep venous thrombosis (DVT) remain unclear.
Purpose of the Study:
- To determine the incidence and etiological mechanisms of superficial venous reflux after acute lower extremity DVT.
- To investigate the relationship between superficial venous thrombosis and subsequent reflux.
Main Methods:
- Serial venous duplex ultrasound examinations were performed on patients with acute lower extremity DVT.
- Reflux in the greater saphenous vein (GSV) and lesser saphenous vein (LSV) was assessed using pneumatic cuff deflation.
Main Results:
- The cumulative incidence of GSV reflux at 8 years was 77.1% in DVT limbs with GSV involvement and 28.9% in those without.
- Superficial venous thrombosis was present in 21.7% of affected limbs.
- Only 49% of observed GSV reflux could be attributed to superficial thrombosis.
Conclusions:
- Superficial venous thrombosis frequently co-occurs with DVT and contributes to superficial reflux.
- A considerable amount of superficial venous reflux develops independently of superficial thrombosis, at a rate similar to unaffected limbs.