|Title: ||Duplex mapping of 2036 primary varicose veins|
|Authors: ||García Gimeno, Miguel Ángel|
Rodríguez Camarero, Santiago
Tagarro Villalba, Salvador
Ramalle Gomara, Enrique
González González, Enma
González Arranz, Miguel Ángel
López García, Diego
Vaquero Puerta, Carlos
|Issue Date: ||2009|
|Publisher: ||Society of Vascular Surgery|
|Description: ||Producción Científica|
|Citation: ||Journal of Vascular Surgery, March 2009, vol. 49, n. 3. p.681-689|
|Abstract: ||Objective: To produce a comprehensive anatomical and hemodynamic ultrasound scan mapping of the whole limb in
patients with primary varicose veins (VVs).
Design: An analysis of venous duplex scans performed on patients referred for treatment of primary VVs.
Methods: A total of 2036 limbs were evaluated, looking for the origin of VVs in the saphenous systems and in the
perforating vein (PV) systems, as well as for the presence of non-saphenous reflux.
Results: The sapheno-femoral junction (SFJ) of the great saphenous vein (GSV) was involved in 1330 limbs (65.3%). We
have noted that finding reflux in the groin does not imply that it originates at that point necessarily, as reflux from the
pelvis or abdominal wall can also cause primary VVs (SFJ reflux, 41.9% and competent SFJ with reflux from proximal
veins, 35.4%). We also noted that analyzing only the presence of reflux in the SFJ of the GSV would miss 10.9% of limbs
of reflux in the SFJ of the anterior accessory GSV. In 237 limbs (11.6%), reflux was observed in the popliteal fossa. In the
PV system, we distinguished those PVs with retrograde flow that acted as an origin of the VVs, and other PVs that acted
as re-entry points. Based on this difference, the location identified as the most frequent origin of VVs in the PV system
was the thigh, specifically in the group of PVs of the medial thigh of the femoral canal, with 85 PVs with a total of 238
incompetent PVs identified. Pure non-saphenous reflux was observed in 162 limbs (8%).
Conclusion: The assumption that the origin of VVs would be exclusively in the sapheno-femoral or sapheno-popliteal
junction, is a mistaken attitude and a comprehensive duplex scan mapping is recommended. ( J Vasc Surg 2009;49:|
|Peer Review: ||SI|
|Appears in Collections:||DEP11 - Artículos de revista|