Document Detail


Most incompetent calf perforating veins are found in association with superficial venous reflux.
MedLine Citation:
PMID:  11700474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The indications for surgical perforator interruption remain undefined. Previous work has demonstrated an association between clinical status and the number of incompetent perforating veins (IPVs). Other studies have demonstrated that correction of IPV physiology results from abolition of saphenous system reflux. The purpose of this study was to identify which, if any, patterns of venous reflux and obstruction are particularly associated with IPV.
PATIENTS AND METHODS: Two hundred thirty patients and subjects (103 men, 127 women, 308 limbs) with varying grades of venous disease were examined both clinically and with duplex ultrasound scan. The odds ratios (ORs) for the presence of IPVs were calculated for different anatomical distributions of main-stem venous reflux and obstruction. The base group are those with no main-stem venous disease.
RESULTS: There were no significant associations between the proportions of limbs demonstrating IPVs and patient age or sex. The ORs for the presence of IPVs in association with other venous disease are as follows (age/sex adjusted): long saphenous vein reflux, OR = 1.86, range = 1.32-2.63; short saphenous vein reflux, OR = 1.36, range = 1.02-1.82; deep system venous reflux, OR = 1.61, range = 1.2-2.15; superficial system reflux, OR = 3.17, range = 1.87-5.4; and deep system obstruction, OR = 1.09, range = 0.51-2.33. The ORs for combinations of venous disorders were calculated. Combinations of disease produced higher odds for the presence of IPVs than those above, the highest being long saphenous vein, short saphenous vein, and deep reflux combined, OR = 6.85 (95% CI, 2.97-15.83; P =.0001).
CONCLUSIONS: Although the presence of IPVs is associated with venous ulceration, the highest ORs for the presence of IPVs were found in patients with superficial disease alone or in combination with deep reflux. Many of these may be corrected by saphenous surgery alone.
Authors:
W P Stuart; A J Lee; P L Allan; C V Ruckley; A W Bradbury
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  34     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-08     Completed Date:  2001-12-14     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  774-8     Citation Subset:  IM    
Affiliation:
Vascular Surgery Unit, Royal Infirmary, Edinburgh, United Kingdom. wesley.stuart@talk21.com
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Leg / blood supply
Male
Middle Aged
Regional Blood Flow / physiology
Saphenous Vein / physiopathology,  surgery
Ultrasonography, Doppler, Duplex
Venous Insufficiency / diagnosis*,  physiopathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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