Definition of venous reflux in lower-extremity veins

Labropoulos, Nicos; Tiongson, Jay; Pryor, Landon; Tassiopoulos, Apostolos K.; Kang, Seung-Min; Mansour, M. Ashraf; Baker, William H.

doi:10.1016/s0741-5214(03)00424-5

Cited by 417 publications

(306 citation statements)

References 16 publications

Supporting

Mentioning

272

Contrasting

Unclassified

Order By: Relevance

“…A reflux time of Ͼ0.5 (or 1.0) second has been used to diagnosis the presence of reflux, although a more refined definition with a variable "cutoff" based on location has been suggested. 38 The longer the duration of reflux or the greater the reflux time implies more severe disease. Other parameters such as the reflux velocity and even the calculated reflux volume have been used to assess the severity of reflux.…”

Section: Venous Duplex Imagingmentioning

confidence: 99%

Chronic Venous Insufficiency

2005

View full text Add to dashboard Cite

C hronic venous disease is often overlooked by primary and cardiovascular care providers because of an underappreciation of the magnitude and impact of the problem. The importance of chronic venous disease is related to the number of people with the disease and the socioeconomic impact of its more severe manifestations. Unfortunately, the literature concerning the prevalence and incidence of chronic venous disease has varied greatly because of differences in the methods of evaluation, criteria for definition, and the geographic regions analyzed. The most common manifestations of chronic venous disease are dilated cutaneous veins, such as telangiectases and reticular veins, and varicose veins. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling, edema, skin changes, and ulcerations. Although the term CVI is often used to exclude uncomplicated varicose veins, varicose veins have incompetent valves with increased venous pressure leading to progressive dilation and tortuosity. We will use the term CVI to represent the full spectrum of manifestations of chronic venous disease.Varicose veins have an estimated prevalence between 5% to 30% in the adult population, with a female to male predominance of 3 to 1, although a more recent study supports a higher male prevalence. 1 The Edinburgh Vein Study screened 1566 subjects with duplex ultrasound for reflux finding CVI in 9.4% of men and 6.6% of women, after age adjustment, which rose significantly with age (21.2% in men Ͼ50 years old, and 12.0% in women Ͼ50 years old). 2 The San Valentino Vascular Screening Project found among the 30 000 subjects evaluated by clinical assessment and duplex ultrasound a prevalence of 7% for varicose veins and 0.86% for "symptomatic" CVI. 3 As in previous studies, CVI was more common with increasing age, but there was no significant sex difference. The rate of varicose vein development may be estimated from the Framingham Heart Study, which found an annual incidence of 2.6% in women and 1.9% in men. 4 Risk factors found to be associated with CVI include age, sex, a family history of varicose veins, obesity, pregnancy, phlebitis, and previous leg injury. 5,6 There also may be environmental or behavioral factors associated with CVI such as prolonged standing and perhaps a sitting posture at work. 6,7 Varicose veins have a significant impact on healthcare resources, with millions of people seeking medical attention for their cosmetic appearance annually. Although often minimized, the cosmetic consequences may adversely affect an individual's quality of life and are associated with other manifestations.The more serious consequences of CVI such as venous ulcers have an estimated prevalence of Ϸ0.3%, although active or healed ulcers are seen in Ϸ1% of the adult population. 8 It has been estimated that Ϸ2.5 million people have CVI in the United States, and of those, Ϸ20% develop venous ulcers. 9 The ov...

show abstract

Section: Venous Duplex Imagingmentioning

confidence: 99%

Chronic Venous Insufficiency

2005

View full text Add to dashboard Cite

show abstract

“…Pelvic varicose veins were defined as the presence of dilated (diameter ≥ 7 mm), tortuous vessels, with reflux (presence of bidirectional flow during Valsalva's maneuver) in the adnexal region 11,13 ( Figure 1). Selective pelvic phlebography was performed using a Philips® device and the Seldinger technique.…”

mentioning

confidence: 99%

Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography

Barros¹,

Perez

Zandonade

et al. 2010

J. vasc. bras.

View full text Add to dashboard Cite

Introduction: Pelvic varicose veins, one of the main causes of chronic pelvic pain and dyspareunia, are an important source of reflux for lower limb varicose veins, especially in recurrent cases. Color Doppler ultrasound of the lower limbs and transvaginal ultrasound are the noninvasive diagnostic methods most commonly used to assess pelvic venous insufficiency, whereas phlebography is still considered as the gold standard. Objectives: To determine the prevalence of lower limb varicose veins originating from the pelvis in a group of female patients and to determine the agreement between results obtained via color Doppler ultrasound of the lower limbs, transvaginal ultrasound, and phlebography. Methods: The sample comprised female patients referred to a vascular laboratory for lower limb screening. Patients diagnosed with deep venous thrombosis were excluded. Data analysis included kappa coefficient of agreement, McNemar' s test, sensitivity and specificity values. Results: Of a total of 1,020 patients, 124 (12.2%) had findings compatible with reflux of pelvic origin. Among these patients, 51 (41.2%) were recurrent cases. A total of 249 were submitted to transvaginal ultrasound. There was significant agreement between lower limb ultrasonographic findings and transvaginal findings. Phlebography was performed in 54 patients. The comparison between transvaginal ultrasound and phlebography was associated with a 96.2% sensitivity and 100% specificity. Conclusions: The authors draw attention to the relatively high prevalence of lower limb varicose veins originating from the pelvis, suggesting an important but underdiagnosed cause of recurrent varicose veins.

show abstract

“…Duration of refl ux (refl ux time) of more than one second is considered pathological for the common femoral, femoral, and popliteal veins [42]. For other superfi cial and deep veins of the lower limb, a cut-off value of 500 ms is recommended [16] (Figure 5b).…”

Section: Ultrasound Characteristics Of Venous Refl Ux and Refl Ux-promentioning

confidence: 99%

“…For other superfi cial and deep veins of the lower limb, a cut-off value of 500 ms is recommended [16] (Figure 5b). For perforating veins, cut-off values of both 350 ms and 500 ms have been proposed in the literature [6,42]. Furthermore, beside refl ux time, a perforating vein diameter of more than 3.5 mm at the point where it passes through the muscle fascia ( Figure 4c) has been evaluated as surrogate marker to defi ne incompetence [43].…”

Section: Ultrasound Characteristics Of Venous Refl Ux and Refl Ux-promentioning

confidence: 99%

“…Furthermore, beside refl ux time, a perforating vein diameter of more than 3.5 mm at the point where it passes through the muscle fascia ( Figure 4c) has been evaluated as surrogate marker to defi ne incompetence [43]. Refl ux testing should generally be performed in an upright position [42] with the help of provocation manoeuvres while insonating the vein segment of interest with colour or pulsed-wave Doppler. Colour Doppler testing can be performed with a steeply upward-angled transverse view as simple screening method or on a longitudinal view using a correct angle of insonation.…”

Section: Ultrasound Characteristics Of Venous Refl Ux and Refl Ux-promentioning

confidence: 99%

See 1 more Smart Citation

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

Spinedi

Brož

Engelberger

et al. 2017

Vasa

View full text Add to dashboard Cite

Summary:Lower extremities varicose veins are among the most frequent diseases in the general population. They can cause complaints with a deterioration of the quality of life and are associated with potentially threatening clinical conditions such as chronic venous ulceration, haemorrhage from ruptured varicose veins, and venous thromboembolism. An accurate diagnostic work-up is crucial to confi rm the presence and the extension of the venous problem, in order to obtain an optimal management of the condition. In the past years, great efforts have been made to reach an international consensus on the terminology, the symptomatology, the classifi cation, and the duplex ultrasound examination of lower extremities varicose veins. Mainly guided by these consensus documents, the present article describes the diagnostic work-up of lower extremities varicose veins, based on a careful medical history, physical examination, and duplex ultrasound examination.

show abstract

Definition of venous reflux in lower-extremity veins

Cited by 417 publications

References 16 publications

Chronic Venous Insufficiency

Chronic Venous Insufficiency

Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

Contact Info

Product

Resources

About