Quantification of Superficial Venous Reflux by Duplex Ultrasound—Role of Reflux Velocity in the Assessment the Clinical Stage of Chronic Venous Insufficiency

Abstract

Objectives: This study we compare the duplex-derived parameters of reflux in patients with early and advanced superficial venous insufficiency (SVI) to identify parameters reflecting this.Methods: Two thousand and one hundred sixty limbs with primary reflux, categorized according to the CEAP (clinical, etiologic, anatomic and pathophysiologic) classification, and the patients were divided into two groups (group I [C_1–3, E_p, A_s, P_r]; group II [C_4–6, E_p, A_s, P_r]) were studied. The vein diameter, reflux duration(s), mean reflux velocity (MRV; cm/s), peak reflux velocity (PRV; cm/s), and total reflux volume (TRV; ml/s) were determined at the sapheno-femoral junction (SFJ), great saphenous vein (GSV) and sapheno-popliteal junction (SPJ).Results: Age and the proportion of males were greater in group II. MRV, PRV and TRV were greater in group II at the SFJ, SPJ and in GSV (p <0.01 for all), although the duration of SPJ reflux was non-discriminatory (p = 0.78). From receiver operating characteristic (ROC) curve, optimal cut-off points of 27.8, 47.8, and 36.2 cm/s for the PRV at the SFJ (p <0.01), GSV (p <0.01), and SPJ (p <0.01) discriminated between the two groups.Conclusion: PRV and MRV improved discrimination between early and advanced SVI compared to reflux duration.