title: Great saphenous vein diameter does not correlate with worsening quality of life scores in patients with great saphenous vein incompetence.
abstract: OBJECTIVE
  Previous studies have correlated increasing great saphenous vein (GSV) diameter with increasing CEAP clinical classification. Some insurance carriers are currently using specific GSV diameters to determine coverage for treatment of axial venous insufficiency. The aim of this study was to investigate the correlation of patient quality of life (QOL) measures with GSV diameters in varicose vein patients with GSV reflux.
  
  
  METHODS
  Data were collected from the records of 91 patients prospectively enrolled in two varicose vein trials. The patients had symptomatic varicose veins with saphenofemoral junction and proximal GSV reflux. Maximum GSV diameter was measured on duplex ultrasound imaging, with the patient standing, within 5 cm of the saphenofemoral junction. Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2; Servier, Neuilly-sur-Seine, France), Venous Insufficiency Epidemiological and Economic Study (VEINES) Symptom (Sym) and QOL assessments, and the Venous Clinical Severity Score (VCSS) assessment were completed before treatment of GSV insufficiency. Demographic information, patient weight, height, and body mass index were collected. Correlations between pairs of data were done using Pearson product-moment and Spearman correlation coefficients.
  
  
  RESULTS
  The 91 study patients (19 men, 72 women) were a mean age of 45 years (range, 18-65 years). The mean GSV diameter was 6.7 mm (range, 2.2-14.1 mm). The mean VCSS score was 7.8 (range, 3-12). There was a weak correlation between increasing GSV diameter and VCSS (r=0.23; P=.03) and no correlation between GSV diameter and the CIVIQ-2 score (r=0.01), VEINES-QOL (r=-0.07), and VEINES-Sym (r=-0.1).
  
  
  CONCLUSIONS
  GSV diameter is a poor surrogate marker for assessing the effect of varicose veins on a patient's QOL; thus, using GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux is inappropriate. Further correlations between QOL measures and duplex-derived objective findings are warranted.
authors.affiliation: Lake Washington Vascular Surgeons, Bellevue, WA 98004, USA. drgibson@lkwv.com
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gibson
authors.forename: Mark
authors.initials: M
authors.lastname: Meissner
authors.forename: David
authors.initials: D
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D018579:Patient Selection; D011788:Quality of Life; D012307:Risk Factors; D012501:Saphenous Vein / Q000473:pathology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014648:Varicose Veins / Q000150:complications* / Q000523:psychology / Q000628:therapy; D014689:Venous Insufficiency / Q000150:complications* / Q000523:psychology / Q000628:therapy; D055815:Young Adult