A clinico-radiological survey of deep venous thrombosis of the leg

In a clinico-radiological survey of 150 cases of varicose veins of the leg, 44 had primary varicosities with no dermal complications; their venograms showed patency of the deep veins of the leg. In 106 cases presenting dermal complications, venographic evidence of deep venous occlusion was present. The dermal complications of varicosities are, therefore, always secondary to deep venous occlusion. Deep venous occlusion of the leg was confined to the lower 1/3 of the leg in 58% of the cases occurring as a complication of silent varices. In 15% it involved the upper 1/3. This lesion complicated trauma and surgical operations. In 5% thrombosis occurred in the muscular sinusoids as a complication of septicaemia. In 22%, deep venous occlusion in lower 1/3 of the leg extended to the middle and upper thirds with a corresponding ascending aggravation of the clinical picture. The underlying factors in the pathogenesis of dermal complications are discussed as well as the role of the lymphatics. The reported classification of deep venous occlusion of the leg may prove of value if a venographic study is not feasible. A review of the various types of treatment is presented in the light of these informations.