Hemodynamic assessment of femoropopliteal venous reflux in patients with primary varicose veins.
OBJECTIVE
The aim of this study was to assess the anatomic distribution and extent of deep venous reflux in patients with primary varicose veins (PVVs) and to investigate its influence on venous hemodynamics.


METHODS
Femoropopliteal venous reflux was examined using duplex color Doppler ultrasonography in 356 limbs with PVVs in 240 patients. Photoplethysmography (PPG) was performed using above-knee and below-knee tourniquets to determine the contributions of deep and superficial venous insufficiency.


RESULTS
Of 356 limbs with PVVs, 61 (17.1%) had femoropopliteal venous reflux, 42 (11.8%) had superficial femoral venous reflux alone, and 57 (16.0%) had popliteal venous reflux alone. Femoropopliteal venous reflux was associated significantly with clinical symptoms and shortened the half venous refilling time measured by PPG, especially in the presence of incompetent perforating veins. These findings were obtained regardless of the presence of long saphenous vein reflux.


CONCLUSIONS
Femoropopliteal venous reflux associated with PVVs plays an important role in the pathophysiologic mechanism of venous stasis and influences venous hemodynamics in the presence of incompetent perforating veins and short saphenous vein.
Sakurai
T
T
First Department of Surgery, Nagoya University School of Medicine, Japan.
Matsushita
M
M
Nishikimi
N
N
Nimura
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017156:Photoplethysmography; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler; D014648:Varicose Veins / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*