title: Duplex-derived valve closure times fail to correlate with reflux flow volumes in patients with chronic venous insufficiency.
abstract: The best way to quantitate venous reflux is still a matter of debate. Duplex-derived valve closure time (VCTs) have been used recently because they can be measured easily. We examined the relationships between VCT and duplex-obtained quantitation of venous volume and between VCT and air plethysmography (APG). Sixty-nine legs in 45 patients with varying clinical degrees of chronic venous insufficiency were studied by duplex scan and APG. VCTs were compared with duplex-derived flow calculations and with APG-derived venous filling index and residual volume fraction. The patient's mean age was 47.5 +/- 13.9 years; the mean duration of their symptoms was 13 +/- 4 years. Twenty percent had a history of deep venous thrombosis, and 29% had undergone venous surgery. No correlation was found between VCT and flow volume or between VCT and flow at peak reflux at any of the anatomic locations studied: saphenofemoral junction, greater saphenous vein, lesser saphenous vein, superficial femoral vein, profunda femoris vein, and popliteal vein. Likewise, no correlation was found between total VCT and APG-derived venous filling index or between total flow volumes and APG-derived residual volume fraction. Total VCT and total flow volumes did, however, have a moderate correlation (r = 0.65; p = 0.0003). Duplex-derived VCTs, although extremely useful in determining the presence of reflux, do not correlate with the magnitude of reflux, and should not be used to quantitate the degree of reflux.
authors.affiliation: Department of Surgery, Tufts University School of Medicine, Boston, MA 02111, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Rodriguez
authors.forename: C M
authors.initials: CM
authors.lastname: Whitehead
authors.forename: R L
authors.initials: RL
authors.lastname: McLaughlin
authors.forename: S E
authors.initials: SE
authors.lastname: Umphrey
authors.forename: H J
authors.initials: HJ
authors.lastname: Welch
authors.forename: T F
authors.initials: TF
authors.lastname: O'Donnell
mesh_terms: D000388:Air; D001810:Blood Volume; D002908:Chronic Disease; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D013924:Thrombophlebitis / Q000503:physiopathology; D018616:Ultrasonography, Doppler, Duplex; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery