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Ultrasound assessment is linked to histological vein wall thickness in chronic venous disease
Sammi Zerrouk1,2, Paolo Casoni3, Edoardo Cervi4
1Naborvein Institute, Saint Avold, France.
Insights
Duplex ultrasound assessment of vein wall thickness (VWT) is a non-invasive tool for diagnosing chronic venous disease (CVD). This method shows high sensitivity and specificity, aiding in treatment optimization.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Histopathology
Background:
- Chronic venous disease (CVD) diagnosis often relies on invasive methods.
- Limited comparative studies exist for ultrasound and histological assessments in CVD patients.
Purpose of the Study:
- To evaluate the diagnostic performance of duplex ultrasound (US) for vein wall thickness (VWT) in patients with CVD.
- To compare US VWT assessment with histological VWT measurements.
Main Methods:
- A prospective, two-center study included 38 adults with primary varicose veins.
- Vein wall thickness (VWT) of the Posterior Accessory Great Saphenous Vein (PASV) was measured using both duplex ultrasound (US) and microscopy.
- Microscope-assessed VWT > 0.5 mm was considered high.
Main Results:
- Optimized US performance achieved 92.9% sensitivity and 91.7% specificity with a 0.6 mm threshold.
- Positive predictive value was 86.7%, and negative predictive value was 95.7%.
- Likelihood ratios indicated strong diagnostic utility.
Conclusions:
- Duplex ultrasound assessment of VWT is a viable non-invasive tool for CVD diagnosis and follow-up.
- VWT measurements complement diameter and reflux data for treatment optimization.
- US VWT can inform energy levels for endovenous laser ablation and concentration for chemical ablation.
Objectives:
Few studies compared both ultrasound and histological approaches for the same series of patients with chronic venous disease (CVD). We aimed to assess the diagnostic performances of duplex ultrasound assessment (US) of Vein Wall Thickness (VWT) among patients with CVD.
Methods:
38 adults with primary varicose veins having undergone Great Saphenous Vein thermal ablation with phlebectomy, and agreeing to biopsy of the Posterior Accessory Great Saphenous Vein (PASV) were consecutively included in a two-center prospective study. VWT assessment of the PASV was performed using both US, and microscope examination. High values for microscope-assessed VWT were defined at > 0.5 mm.
Results:
The mean age was 53.0 ± 13.1 years, 71% were women. Maximization of US performances was obtained with a threshold of 0.6 mm: Sensitivity (Se) = 92.9%, Specificity (Sp) = 91.7%, positive (86.7%) and negative predictive value (NPV) (95.7%), positive (11.1) and negative likelihood ratio (NLR) (0.07).
Conclusions:
US assessment of VWT could be a non-invasive tool for diagnosis and follow-up in CVD, and an interesting in vivo parameter complementing diameter and reflux measures, with a view to optimizing treatment. It could help to determine i) the energy level necessary in case of endovenous laser ablation, and ii) the sclerosing agent concentration in case of chemical ablation.
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