Correlation between Duplex-derived Peak Reflux Velocity and Diameters of the Saphenous Veins in Superficial Venous Insufficiency

Abstract

Background: The purpose of this study was to evaluate the significance of venous diameter as a parameter predicting severity of valvular incompetence in patients with superficial venous insufficiency. Correlation between duplex-derived parameters and diameters both of the great saphenous and small saphenous veins was assessed.

Objective and study design: Between August 2007 and April 2008, a total of 206 limbs in 103 patients with various clinical degrees of primary varicose veins were examined using ultrasound sonography. Eighty-six percents of 206 limbs were without any skin changes or totally asymptomatic. Valvular incompetence of saphenofemoral (SFJ) and saphenopopliteal junction (SPJ) was assessed using manual compression technique with patients in standing and bedside-sitting positions respectively. The great saphenous vein (GSV) diameter was measured on standing at just below the SFJ, midthigh and below the knee. The small saphenous vein (SSV) diameter was measured on sitting at the upper calf portion. The GSV and SSV diameters were compared statistically with the duplex-derived reflux parameters including peak reflux velocity (emfs) and reflux time (s).

Result: Peak reflux velocity at the SFJ correlated with the GSV diameter only at the midthigh (r=0.48) and that at the SPJ correlated well with the SSV diameter (r=0.79). Reflux time did not have significant correlation with diameters at any sites. The GSV diameter less than 3.5 mm or the SSV diameter less than 2.5 mm predicted no abnormal reflux, while the GSV diameter of 7 mm or greater or the SSV diameter of 5 mm or greater predicted critical reflux.

Conclusion: Duplex-derived peak reflux velocity correlated with venous dilation both in the GSV and SSV. The diameter of the saphenous veins appeared to be a useful measure in predicting the degree of the proximal valvular imcompetence.