TY - JOUR
TI - Ultrasonographic hemodynamical and epidemiological factors in
advancement of clinical manifestations in primary varicose veins
AU - Pitoulias, Apostolos G.
AU - Chatzelas, Dimitrios
AU - Kalogirou, Thomas
AU - E.
AU - Politi, Loukia A.
AU - Pitoulias, Matthaios G.
AU - Roussas,
AU - Nikolaos
AU - Kakisis, Ioannis
AU - Giannoukas, Athanasios D. and
AU - Pitoulias, Georgios A.
JO - International Angiology
PY - 2021
VL - 40
TODO - 5
SP - 359-367
PB - Edizioni Minerva Medica
SN - 0392-9590
TODO - 10.23736/S0392-9590.21.04650-2
TODO - Bile reflux; Varicose veins; Saphenous vein; Femoral vein; Epidemiology
TODO - Background: Primary varicose veins (PVV) represent the most prominent
clinical manifestation of chronic venous disease (CVD) and has a complex
pathophysiological background. The aim of our study was to investigate
the impact of sonographic hemodynamical and contemporary epidemiological
factors on the clinical severity of PVV. Methods: We analyzed the
sonographic hemodynamical and clinical parameters from 159 consecutive
CVD patients and 233 lower limbs with PVV of clinical stages C2, C3 and
C4. Univariate and logistic regression analysis was performed between
patients of C2 (N.=70 -30.0%) and C3 -4 stages and between subgroups C3
(N.=101 -43.3%) and C4 (N.=62 -26.6%). Results: Reflux of common
femoral vein and saphenofemoral junction was detected in 43.3% and
65.7%. High venous reflux rates were found at the great saphenous above
and below knee (90.1% -53.2%) and in Cockett perforators (80.5%).
Logistic regression revealed that factors associated with the
symptomatic C3; 4 stages were the duration of disease >10 years
(P=0.015, insufficiency in two or more perforators (P<0.001) and history
of 2 pregnancies (P=0.001). Analysis C3 vs. C4 showed that insufficiency
in two or more perforators increased the likelihood of advanced C4
clinical stage by 2.2 times, (P=0.037). An additional significant factor
was the presence of at least one incompetent Cockett perforator.
Conclusions: Clinical severity of PVV is correlated with a plethora of
complex anatomical, hemodynamical and epidemiological factors.
Insufficiency in two or more perforators seems to play the most
important role and this highlights the value of preoperative venous
ultrasound mapping.
ER -