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Leg perforator vein incompetence: functional anatomy.
1Department of Vascular Surgery, St Mary's Hospital, Imperial College School of Medicine, London, England. k.delis@ic.ac.uk
Radiology
|March 8, 2005
Summary
Incompetent perforator veins (IPVs) show reflux patterns linked to chronic venous disease (CVD) severity. Superficial and deep reflux in IPVs increases with CVD clinical class, particularly in the calf and thigh.
Area of Science:
- Vascular Surgery
- Phlebology
- Medical Imaging
Background:
- Chronic venous disease (CVD) affects a significant portion of the population.
- Incompetent perforator veins (IPVs) play a role in the pathophysiology of CVD.
- Understanding the anatomic patterns of IPV reflux is crucial for effective treatment.
Purpose of the Study:
- To determine the anatomic patterns of IPV reflux.
- To correlate these patterns with the distribution of valvular incompetence in calf and thigh veins.
- To analyze these patterns across the clinical spectrum of CVD.
Main Methods:
- Retrospective analysis of 505 limbs from 359 patients with suspected CVD.
- Clinical stratification using the CEAP classification (C0-C6).
- Duplex ultrasonography for venous hemodynamic investigation and identification of IPVs and deep venous reflux.
Main Results:
- IPV reflux increased with CEAP clinical class (P < .01).
- The most common IPV sites were the medial calf and medial thigh.
- IPVs with both superficial and deep reflux increased with CEAP class (P < .02), linked to clinical severity but not specific anatomic site.
Conclusions:
- Perforator vein reflux patterns are associated with the clinical severity of CVD.
- IPV reflux patterns are anatomically distributed but not site-specific.
- The prevalence of IPVs with combined superficial and deep reflux increases with CVD severity.