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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Correlation of Clinical Class with Duplex Ultrasound Findings in Lower Limb Chronic Venous Disease

Ki Pyo Hong1

  • 1Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Journal of Chest Surgery
|April 28, 2022
PubMed

Insights

This study on chronic venous disease (CVD) found that advanced CEAP classifications (C3-C6) did not correlate with specific reflux patterns. Duplex ultrasonography is crucial for planning treatment in all CEAP categories, especially C0s-C1.

Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Clinical Diagnostics

Background:

  • Chronic venous disease (CVD) affects a significant portion of the population.
  • Accurate classification and understanding of venous valve incompetence are essential for effective treatment.
  • The Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification system is widely used to stage CVD.

Purpose of the Study:

  • To investigate the distribution of venous valve incompetence in patients with CVD.
  • To correlate the findings of valve incompetence with the CEAP classification.
  • To evaluate the utility of duplex ultrasonography in diagnosing and managing CVD.

Main Methods:

  • A cohort of 1,386 limbs with suspected CVD were analyzed.
  • Limbs were classified using the CEAP system.
  • Duplex ultrasonography was performed to assess venous valve function and reflux patterns.

Main Results:

  • Saphenous vein incompetence was prevalent, particularly in earlier CEAP stages (C0s-C1).
  • The saphenofemoral junction (SFJ) was competent in a notable proportion of limbs with more advanced CEAP classifications (C2-C6).
  • CEAP categories C3-C6 showed no significant correlation with saphenous vein reflux, SFJ reflux, deep vein reflux, or great saphenous vein (GSV) incompetence distribution.

Conclusions:

  • Duplex ultrasonography is vital for treatment planning across all CEAP stages, especially C0s-C1.
  • Flush ligation of the GSV may not always be necessary in CEAP C2-C6 patients with SFJ competence.
  • The CEAP C3-C6 classification has limited predictive value for specific venous reflux patterns.
Abstract

Keywords:
Duplex ultrasonographySaphenous veinVenous insufficiency

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