title: Prevalence of varicose veins and venous anatomy in patients without truncal saphenous reflux.
abstract: OBJECTIVE
  To determine the prevalence and distribution of primary venous reflux in the lower limbs in patients without truncal saphenous reflux.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  One thousand and seven hundred and twelve patients with suspected venous disease were examined by duplex ultrasonography. Seven hundred and thirty-five patients had primary varicose veins with competent saphenous trunks. Limbs with truncal saphenous reflux, deep vein reflux or obstruction, previous injection sclerotherapy or vein surgery, arterial disease and inflammation of non-venous origin were excluded from further consideration. The CEAP classification system was used for clinical staging. Systematic duplex ultrasound examination was undertaken to assess the distribution of incompetent saphenous tributaries.
  
  
  RESULTS
  The prevalence of primary reflux with competent saphenous trunks was 43%. Reflux of GSV calf tributaries was the most common. The majority of the limbs (96%) belonged to chronic venous disease classes C1 and C2 of the CEAP classification.
  
  
  CONCLUSIONS
  Superficial venous reflux causing varicose veins in the presence competent saphenous trunks is very prevalent in this series in contrast to other studies, presumably reflecting differing patient populations. Our data clearly show that varicose veins may occur in any vein and do not depend on truncal saphenous incompetence. Careful duplex ultrasound evaluation allows the pattern of venous reflux to be established in this group of patient ensuring appropriate management of varices.
authors.affiliation: Maringá State University, Maringá, Rua Gerardo Braga, 118 CEP 87050-610-Maringá, Paraná, PR, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Seidel
authors.forename: F
authors.initials: F
authors.lastname: Miranda
authors.forename: Y
authors.initials: Y
authors.lastname: Juliano
authors.forename: N F
authors.initials: NF
authors.lastname: Novo
authors.forename: J H
authors.initials: JH
authors.lastname: dos Santos
authors.forename: D F
authors.initials: DF
authors.lastname: de Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008333:Mandelic Acids; D008709:Methenamine / Q000031:analogs & derivatives*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D012501:Saphenous Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D014654:Vascular Patency / Q000502:physiology
chemical_list: D008333:Mandelic Acids; C023055:methenamine mandelate; D008709:Methenamine