Global venous function correlates better than duplex derived reflux to clinical class in the evaluation of chronic venous disease.
OBJECTIVE
To compare the symptoms and signs of patients with chronic venous disease with the objective results of duplex ultrasound and plethysmography (foot volumetry).


METHODS
One hundred and one patients with symptomatic chronic venous disease were investigated with duplex ultrasound and foot volumetry. Patients were classified according to the CEAP classification and the symptoms of pain, heaviness, tiredness, ankle swelling and night cramps were graded. The severity of the disease was judged objectively by the reflux time (sum of reflux time at 6 levels) and the venous function was measured globally with expelled volume (ml) and refilling rate (Q) (ml/100 mlxmin) after exercise, and expelled volume related to foot volume (EVrel), (ml/100 ml). The ratio Q/EVrel)was calculated. Correlation was calculated between clinical class, symptoms and objective parameters.


RESULTS
The correlation analyses showed a clear constant relationship between the CEAP clinical classification and the foot volumetry measures (Q/EVrel), r=0.48; p<0.01) There was no such relationship between clinical class and the sum of duplex calculated reflux time (r=-0.05), or between foot volumetry and reflux time. There was no correlation between the clinical class and the total score of symptoms (r=0.044).


CONCLUSIONS
The clinical class of CEAP classification correlates significantly with foot volumetry parameters. There is no correlation between clinical class and reflux time. The severity of the venous disorder and subsequently the need for treatment is more accurately judged by foot volumetry as a global measure. Clinical classification has a realistic meaning concerning the functional evaluation of venous disease.
Danielsson
G
G
Department of Surgery, Lund University Hospital, Lund, Sweden. gudmundur.danielsson@skane.se
Norgren
L
L
Jungbeck
C
C
Peterson
K
K
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D005528:Foot / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013548:Sweden; D018616:Ultrasonography, Doppler, Duplex; D014689:Venous Insufficiency / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*