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Quantifying saphenous reflux.

Seshadri Raju¹, Mark Ward¹, Tamekia L Jones²

¹The Rane Center at St. Dominic Hospital, Jackson, Miss.

Journal of Vascular Surgery. Venous and Lymphatic Disorders

|March 20, 2016

Summary

This summary is machine-generated.

Saphenous vein size alone does not indicate significant reflux in chronic venous disease. Calf pump function assessment is crucial alongside reflux volume for accurate diagnosis and treatment planning.

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Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

Published on: October 1, 2014

Area of Science:

Vascular Medicine
Phlebology
Ultrasound Diagnostics

Background:

Quantifying venous reflux is essential in advanced chronic venous disease due to its impact on ambulatory venous pressure (AMVP).
Clinical observation suggested saphenous vein diameter >5 mm indicates significant reflux.
A hypothesis proposed reflux volume ≥30 mL is needed to disrupt calf pump equilibrium.

Purpose of the Study:

To investigate the relationship between saphenous vein size, reflux volume, and calf pump function.
To determine if a specific reflux volume threshold reliably predicts adverse clinical outcomes.
To evaluate the necessity of calf pump assessment in managing chronic venous disease.

Main Methods:

Analysis of venous laboratory data from 119 limbs with isolated saphenous reflux.
Calculation of reflux volume using duplex ultrasound (area × velocity × duration).
Examination of correlations between reflux volume, saphenous vein size, calf pump function (air plethysmography, AMVP), and clinical severity.

Main Results:

Saphenous vein size showed a bimodal relationship with reflux volume; ≥30 mL reflux occurred in 97% of limbs with saphenous veins ≥5.5 mm, but 51% of veins >5.5 mm had <30 mL reflux.
Ambulatory venous pressure (AMVP) association with reflux was variable, not based on a ≥30 mL threshold, influenced by calf pump mechanics.
Calf pump abnormalities were prevalent (70% in refluxive limbs, 44% in contralateral limbs), and higher reflux volumes correlated with ulceration (C6), though with overlapping ranges.

Conclusions:

Saphenous vein size is insufficient as an isolated indicator of significant venous reflux.
Over two-thirds of limbs with isolated saphenous reflux exhibit calf pump abnormalities, a finding also noted in limbs without reflux.
Comprehensive assessment including reflux volume quantification and calf pump evaluation (air plethysmography, AMVP) is recommended for clinical classes 3 and higher.