title: A study to evaluate patterns of superficial venous reflux in patients with primary chronic venous disease.
abstract: OBJECTIVE
  This study assessed patterns of superficial reflux in patients with primary chronic venous disease.
  
  
  METHODS
  Retrospective review of all patient venous duplex ultrasonography reports at one institution between 2000 and 2009. Legs with secondary, deep or no superficial reflux were excluded.
  
  
  RESULTS
  In total, 8654 limbs were scanned; 2559 legs from 2053 patients (mean age 52.3 years) were included for analysis. Great saphenous vein reflux predominated (68%), followed by combined great saphenous vein/small saphenous vein reflux (20%) and small saphenous vein reflux (7%). The majority of legs with competent saphenofemoral junction had below-knee great saphenous vein reflux (53%); incompetent saphenofemoral junction was associated with combined above and below-knee great saphenous vein reflux (72%). Isolated small saphenous vein reflux was associated with saphenopopliteal junction incompetence (61%), although the majority of all small saphenous vein reflux limbs had a competent saphenopopliteal junction (57%).
  
  
  CONCLUSIONS
  Superficial venous reflux does not necessarily originate from a saphenous junction. Large prospective studies with interval duplex ultrasonography are required to unravel the natural history of primary chronic venous disease.
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Mahim I
authors.initials: MI
authors.lastname: Qureshi
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Manj
authors.initials: M
authors.lastname: Gohel
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Wing
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: MacDonald
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Chung S
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Ellis
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Franklin
authors.affiliation: Academic Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, UK a.h.davies@imperial.ac.uk.
authors.forename: Alun H
authors.initials: AH
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014463:Ultrasonography; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology
keywords: Chronic venous disease; ascending theory; descending theory; duplex ultrasonography; superficial venous reflux