Patterns of Venous Insufficiency in Patients With Varicose Veins

Hanrahan, Lawrence M.; Kechejian, Gregory J.; Cordts, Paul R.; Rodriguez, Agustin A.; Araki, Clifford A.; LaMorte, Wayne W.; Menzoı́an, James O.

doi:10.1001/archsurg.1991.01410300029003

Cited by 67 publications

(24 citation statements)

References 8 publications

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“…When duplex ultrasound is used on a patient population that also includes smaller veins, it has been shown that segmental or regional reflux frequently occurred in the long saphenous vein, at any level, without evidence of refluxthrough the sapheno-femoral junction or reflux from other 'transfascial escape' sources [5][6][7]. These findings shifted attention from primary valvular incompetence to primary vein wall dilatation as an alternative, more acceptable aetiological explanation [8], Focusing on the sapheno-femoral junction, van Bernmelen and Sumner investigated reflux patterns with duplex ultrasound in patients with varicose veins [9].…”

Section: Introductionmentioning

confidence: 99%

Venous Reflux at the Sapheno-Femoral Junction

et al. 1995

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Objective,: To clarify reflux patterns in the saphenofemoral junction in legs with varicose veins that display incompetence in the proximal long saphenous vein on duplex scan examination. Padenls and method: One hundred consecutive extremities were selected for ultrasound studies. Venous reflux was examined in the common femoral vein and long saphenous vein at five selected levels in the vicinity of the sapheno-femoral junction. Results: Duplex ultrasound examination confirmed that in 44 extremities reflux was detectable both in the long saphenous vein and common femoral vein indicating 'true' sapheno-femoral incompetence. In 56 legs reflux was limited to the long saphenous vein, whilst the first saphenous valve remained competent. The ultrasound examination suggested that in these cases the reflux originated from the numerous tributaries of the proximal long saphenous vein.Conclusion: Our findings emphasize the transfascial escape (reflux from the deep veins) is not a necessary precondition of long saphenous vein incompetence and related varicose veins.

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Section: Introductionmentioning

confidence: 99%

Venous Reflux at the Sapheno-Femoral Junction

et al. 1995

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“…4 It has been well established that varicosities involve the tributaries and the accessory veins. [5][6][7] Varicosities in the main trunk of the great and small saphenous veins (GSV and SSV) have been reported, [5][6][7][8][9] but not the exact distribution and extent throughout the saphenous venous system. Additionally, reflux of the saphenous trunks has been implicated in the development of varicose veins, [10][11][12][13] yet this correlation in conjunction with the distribution of the varicosities remains to be elucidated.…”

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confidence: 99%

The distribution and significance of varicosities in the saphenous trunks

Labropoulos

Kokkosis

Spentzouris

et al. 2010

Journal of Vascular Surgery

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A novel definition for varicosities in the saphenous trunks was established. Using this definition, it was determined that focal dilatations are far more common than varicosities. Because both of these entities are more prevalent in the accessory saphenous veins and tributaries, and CEAP class correlates positively with the extent of reflux and saphenous trunk diameter, studies on earlier interventions are warranted to prevent CVD progression.

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“…[1][2][3] The reported annual incidence of new cases of varicose veins is 2.6% in women and 1.9% in men, with associated costs to the community in terms of lost working hours, hospitalization, and management. 4,5 Two theories have been proposed to describe the pathogenesis of varicose veins: the valvular theory and primary weakness of the venous wall.…”

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confidence: 99%

“…[10][11][12][13] The influence of increased levels of female sex hormones, especially during pregnancy, on venous disorders of the legs has been noted by many investigators. [1][2][3][4][5][14][15][16][17][18][19][20] In addition, estrogen and progesterone receptors were found in sections of venous walls, suggesting an involvement of sex hormones in the pathogenesis of varicose veins by a mechanism that has yet to be identified. [21][22][23][24] To elucidate any effect of sex hormones on veins containing these receptors, we performed this in vivo study during the menstrual cycle in young women.…”

mentioning

confidence: 99%

Changes in the Diameter and Valve Closure Time of Leg Veins Across the Menstrual Cycle

Asbeutah

Al-Enezi

Al-Sharifi

et al. 2014

J of Ultrasound Medicine

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he prevalence of varicose veins is around 25% to 33% in women and 10% to 20% in men. [1][2][3] The reported annual incidence of new cases of varicose veins is 2.6% in women and 1.9% in men, with associated costs to the community in terms of lost working hours, hospitalization, and management. 4,5 Two theories have been proposed to describe the pathogenesis of varicose veins: the valvular theory and primary weakness of the venous wall. 6,7 Both theories have the same end result: ie, the venous valves fail to maintain efficient cephalad blood flow, resulting in retrograde blood flow, which leads to dilated tortuous veins. If not treated, venous hypertension will ensue, with its consequences of hyperpigmentation, ulceration, and lipodermatosclerosis. 8,9 Akram M. Asbeutah, PhD, DMU, AMS, MSVU, Maitha Al-Enezi, BSc, Noura M. Al-Sharifi, BSc, Abdullah Almajran, MSc, James D. Cameron, MD, Barry P. McGrath, MD, Sami K. Asfar, MD Received June 25, 2013, Objectives-The purpose of this study was to determine the changes (if any) in the diameter and valve closure time of the lower limb veins in healthy young nulliparous women at different phases of the menstrual cycle.Methods-Fifty-three young nulliparous women were asked to undergo clinical evaluations and duplex ultrasound examinations of both lower limb veins to monitor changes in the vein diameter and valve closure time at different phases of their menstrual cycles. The vein diameter on B-mode imaging and valve closure time on pulsed Doppler tracing were calculated at days 1 to 4, 14 to 16, and 25 to 28 of the menstrual cycle. Freidman and related samples Wilcoxon signed rank tests were used to determine timerelated changes in venous function.Results-The volunteers' mean age ± SD was 20.60 ± 1.90 years, and their mean body mass index was 23.90 ± 4.90 kg/m 2 . There was a gradual increase in the vein diameter and valve closure time at the specified phases of the menstrual cycle. Friedman and related samples Wilcoxon signed rank tests for venous segment diameter and valve closure time changes between the different phases of the menstrual cycle were performed and showed statistical significance for each venous segment within each limb (P = .003-.025). Also, when adjusted for body mass index, statistical significance existed for the same venous segments in the same limbs (P = .001-.049). There was no statistical significance for the same venous segments at the same phase of the menstrual cycle between limbs (related samples Wilcoxon signed rank test: P = .079-.97).Conclusions-During the menstrual cycle, the lower limb veins show an increase in their diameter and valve closure time. These changes are probably mediated by the female sex hormones.

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Patterns of Venous Insufficiency in Patients With Varicose Veins

Cited by 67 publications

References 8 publications

Venous Reflux at the Sapheno-Femoral Junction

Venous Reflux at the Sapheno-Femoral Junction

The distribution and significance of varicosities in the saphenous trunks

Changes in the Diameter and Valve Closure Time of Leg Veins Across the Menstrual Cycle

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