Deep vein reflux: an assessment by descending phlebography

Area of Science:

• Vascular Medicine
• Phlebology
• Diagnostic Imaging

Background:

• Post-thrombotic syndrome (PTS) is a common complication of deep vein thrombosis.
• Pathological reflux in deep veins is a key factor in PTS development.
• Defining 'normal' venous reflux is crucial for accurate PTS diagnosis.

Purpose of the Study:

• To establish the normal range of deep vein reflux.
• To determine the incidence of pathological reflux in patients with PTS.
• To differentiate normal reflux from pathological reflux in venous disease.

Main Methods:

• Standardized descending phlebography was employed in 51 patients.
• Phlebography was performed in supine positions with a controlled Valsalva maneuver.
• Patients included healthy controls, those with varicose veins, and those with PTS.

Main Results:

• The normal range of venous reflux was determined to be grade 0-2.
• Pathological reflux was identified in 31% of patients with proven deep vein damage due to PTS.
• This incidence highlights a significant subgroup of PTS patients with reflux.

Conclusions:

• A reflux grade of 0-2 represents the normal range in deep veins.
• A 31% incidence of pathological reflux is observed in PTS patients.
• These findings refine diagnostic criteria for PTS and venous reflux assessment.