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A Study of Valvular Incompetencies in the Lower Limb Veins Using Doppler Ultrasound Findings
Sangeetha Arumugam1, Durgavajjala Pragnya Manaswini1, Prudhvinath A Reddy2
1Department of Anatomy, All India Institute of Medical Sciences, Mangalagiri, IND.
Insights
Varicose veins in India predominantly affect males aged 31-40 and females aged 50-60. The medial leg perforator is the most common site of venous reflux, indicating a need for targeted Doppler ultrasound examination.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Medical Research
Background:
- Varicose veins (VV) are a prevalent lower limb venous pathology, with higher incidence in the Indian population.
- Doppler ultrasound (DU) is a key diagnostic tool for assessing venous system abnormalities.
Purpose of the Study:
- To identify the most frequently affected anatomical structures in male and female patients with varicose veins.
- To analyze demographic and clinical data in relation to venous reflux patterns.
Main Methods:
- Retrospective analysis of 200 Doppler ultrasound reports of varicose vein patients.
- Categorization of affected venous structures and CEAP classification.
- Statistical analysis using Pearson's correlation coefficient.
Main Results:
- The medial leg perforator (95%) was the most commonly affected structure in the perforator venous system.
- Great saphenous reflux was observed in 63% of cases.
- Males aged 31-40 (left side predominantly) and females aged 50-60 were the most affected demographic groups.
Conclusions:
- Varicose vein occurrence involves superficial, deep, and perforator veins, with medial leg perforators being most frequently implicated.
- Minimal deep vein involvement was noted in early-stage (C1-C3) varicose veins.
Introduction:
Varicose veins (VV) are one of the most common pathologies associated with the venous system of the lower limb. In the Indian population, its incidence is higher, and it is one of the most commonly encountered cases in the hospital. The study aimed to note the widely affected anatomical structure in male and female varicose patients using Doppler ultrasound (DU) examination findings.
Methods:
A total of 200 Doppler ultrasound reports of varicose patients were retrospectively analyzed and categorized based on the affected structure. The demographic data of all cases, such as age, sex, brief history, signs, symptoms, and affected side of the lower limb, was noted. Anatomical structures causing venous refluxes in the saphenous systems, junctions, and perforating venous systems were noted. Pearson's correlation coefficient was applied to find out its association.
Results:
Out of 200 Doppler reports studied, 133 (67%) were male and 67 (33%) were female patients. The majority, 180 (90%) cases, belonged to C1-C3 stages according to the Clinical, Etiology, Anatomy, and Pathological (CEAP) classification, while 20 (10%) were in C4-C5 stages. Male patients aged between 31 and 40 years were predominantly affected, with their left side being affected most commonly. In female patients, the older age group of 50-60 years was predominantly affected. Great saphenous reflux in the groin due to incompetent terminal valve was noted in 126 (63%) cases. In the perforator venous (PV) system, defects in the medial leg perforator (189 (95%)), posterior leg (92 (46%)), and thigh perforator (20 (10%)) were noted.
Conclusion:
In the present study, the occurrence of varicose veins is due to the involvement of superficial, deep, and perforator veins with varying percentages. Among the structures, the medial leg perforator was predominantly involved, followed by other perforators. Since most patients were in C1-C3 stages, the involvement of deep veins was noted minimally.
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