title: Postural Diameter Change of the Saphenous Trunk in Chronic Venous Disease.
abstract: OBJECTIVE
  The aim of this study was to analyze the correlation between the extent of diameter change from standing to supine position ("postural diameter change," PDC), and patient or duplex ultrasound (DUS) characteristics in lower limbs with and without saphenous trunk (ST) reflux.
  
  
  METHODS
  Measurements were carried out in 193 limbs with primary great saphenous vein, anterior accessory saphenous vein, or small saphenous vein reflux, and 48 control limbs without ST reflux. The inner diameter of the ST was measured with DUS in the standing and lying positions. The PDC, calculated as a percentage, followed the formula: (standing diameter - lying diameter)/standing diameter × 100. Clinical findings (according to the highest "C" - of the CEAP classification), venous clinical severity score, body mass index (BMI), time of visit, and inside and outside temperature were documented. Limbs were divided into two groups using the median value of PDC as a cut off to increase interpretability of the analysis.
  
  
  RESULTS
  The median PDC of the ST was 19% in limbs with ST reflux compared with 24% in control limbs (p = .16). In limbs with and without ST reflux, only older age and increased BMI were independently associated with a low PDC of the ST (R(2) 0.13). In limbs with ST reflux, median PDC was significantly lower in C4-C6 (16%, interquartile [IQR] 8-21) than in C0-C1 (23%, IQR 12-35) or C2-C3 limbs (21%, IQR 11-33; p = .016). In addition, PDC was significantly lower in veins with a large diameter (>7 mm) than in those with a small diameter (p = .003).
  
  
  CONCLUSIONS
  Low PDC of the ST correlates with older age and increased BMI. Whether PDC might become a useful additional DUS tool to classify the severity of chronic venous disease and thereby influence the management strategy should be further investigated.
authors.affiliation: Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands. Electronic address: s.vandervelden@erasmusmc.nl.
authors.forename: S K
authors.initials: SK
authors.lastname: Van der Velden
authors.affiliation: Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M G R
authors.initials: MG
authors.lastname: De Maeseneer
authors.affiliation: Centre de Médecine Vasculaire, Grenoble, France.
authors.forename: O
authors.initials: O
authors.lastname: Pichot
authors.affiliation: Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Nijsten
authors.affiliation: Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: R R
authors.initials: RR
authors.lastname: van den Bos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D005268:Femoral Vein / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein / Q000601:surgery; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014648:Varicose Veins / Q000150:complications / Q000601:surgery; D014689:Venous Insufficiency / Q000175:diagnosis / Q000601:surgery*
keywords: Chronic venous disease; Postural diameter change; Saphenous diameter; Saphenous trunk