Abstract:

Objective: The aim of this study was to reveal patterns of chronic venous insufficiency of lower extremity detected by color Doppler ultrasound and clarify its clinical implications in the patients with varicose veins symptoms. Methods: Between 2006 to 2011, a total of 2006 patients presented with symptoms of venous insufficiency were included in the study. A total of 3938 lower extremity venous systems were examined using color Doppler US. We classified four patterns considering combinations of superficial and deep venous insufficiency. Results: Of 2006 patients, 966 had either single venous insufficiency (790, 82%) or combined insufficiency (176, 18%). Superficial venous insufficiency was observed at the saphenoefemoral junction (SFJ) in 25.5%, at the Great Saphenous Vein (GSV) in 57. 6%, at the Giacomini Vein in 2.4%, at the saphenopopliteal junction in 1.8% and finally at the Small Saphenous Vein (SSV) in 9.1% of the patients. We found multilevel venous insufficiency showing connections at the rate of 51%. We described four patterns as Pattern 1: SFJ insufficiency combined with GSV (97.9%), GSV branching (7.1%), and perforating vein (20.8%) insufficiency, Pattern 2: Deep venous insufficiency combined with SFJ (63.6%), GSV (76.4%), and SSV (16.4%) insufficiency, Pattern 3: SPJ insufficiency combined with SSV insufficiency (95.5%) and Pattern 4: Giacomini Vein insufficiency combined with GSV (67.9%) and SSV (75%) insufficiency. Chronic venous insufficiency may show four different patterns. Our results revealed that SFJ and GSV insufficiency combination and deep venous insufficiency and GSV insufficiency combinations are the most common insufficiency patterns seen in the lower extremity.

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