The Relationship between the Extent of Reflux in the Long Saphenous Vein and the Clinical Severity in Patients with Primary Varicose Veins

Abstract

One hundred and eighty-one limbs of 129 patients with primary varicose veins were investigated the influence of the extent of reflux in the long saphenous vein (LSV) regarding clinical severity by using a duplex scan and photoplethysmography. In the skin changes group which includes pigmentation, eczema, lipodermatosclerosis and venous ulcers, the number of limbs with reflux extending throughout the length of the LSV were significantly higher than that in the simple varicosis group. In the group with limbs with reflux through the whole length of the LSV’ the half venous refilling time (112 VRT) in photoplethysmography was significantly shorter than that in the group with limbs with reflux in only the thigh segment of the LSV (sapheno-femoral junction to below-knee LSV). Moreover, when a below-knee tourniquet was applied to block the superficial vein reflux, no significant difference was observed in the rate of improvement of 1/2 VRT between the limbs with and the limbs without incompetent Cockett perforators. We concluded that the limbs with reflux extending throughout the length of the LSV develop a high degree of venous dysfunction in lower legs and tend to be followed by skin lesions, and in the progression of skin lesion, the incompetence of the superficial vein plays an more important role than the incompetence of perforating veins.