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J Chest Surg

Published online April 28, 2022

Copyright © Journal of Chest Surgery.

Correlation of Clinical Class with Duplex Ultrasound Findings in Lower Limb Chronic Venous Disease

Ki Pyo Hong , M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Correspondence to:Ki Pyo Hong
Tel 82-31-900-0254
Fax 82-31-900-0343
E-mail kipyoh@nhimc.or.kr
ORCID
https://orcid.org/0000-0002-8262-3361

Received: February 3, 2022; Revised: March 20, 2022; Accepted: April 10, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: This study investigated the distribution of valve incompetence in patients with chronic venous disease (CVD) and its correlation with the clinical category of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification.
Methods: In total, 1,386 limbs with clinically suspected CVD were categorized according to the CEAP classification and consecutively underwent duplex ultrasonography between April 2017 and December 2020.
Results: There were 362 limbs in male patients and 1,024 limbs in female patients. The limbs were classified as C0s?C1 (608 limbs, 43.8%), C2 (727 limbs, 52.5%), or C3?C6 (51 limbs, 3.7%). The prevalence of saphenous vein incompetence in CEAP C0s?C1 limbs was 43.6%. The saphenofemoral junction (SFJ) was competent in 37% of CEAP C2?C6 limbs. The CEAP C3?C6 category was not correlated with reflux patterns of the saphenous vein system (Cramer’s V=0.07), incompetent SFJ (Cramer’s V=0.07), deep vein reflux (Cramer’s V=0.03), or the distribution of incompetent segments in the great saphenous vein (GSV) (Cramer’s V=0.11).
Conclusion: Duplex ultrasonography is necessary to formulate a proper treatment plan for limbs categorized as CEAP C0s?C1. The SFJ was competent in more than one-third of CEAP C2?C6 limbs with GSV reflux; as such, flush ligation of the GSV may be unnecessary in these patients. The CEAP C3?C6 category showed no correlations with reflux patterns of the saphenous vein system, SFJ reflux, deep vein reflux, or the distribution of incompetent segments in the GSV.

Keywords: Duplex ultrasonography, Venous insufficiency, Saphenous vein

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J Chest Surg

Published online April 28, 2022

Copyright © Journal of Chest Surgery.

Correlation of Clinical Class with Duplex Ultrasound Findings in Lower Limb Chronic Venous Disease

Ki Pyo Hong , M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Correspondence to:Ki Pyo Hong
Tel 82-31-900-0254
Fax 82-31-900-0343
E-mail kipyoh@nhimc.or.kr
ORCID
https://orcid.org/0000-0002-8262-3361

Received: February 3, 2022; Revised: March 20, 2022; Accepted: April 10, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: This study investigated the distribution of valve incompetence in patients with chronic venous disease (CVD) and its correlation with the clinical category of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification.
Methods: In total, 1,386 limbs with clinically suspected CVD were categorized according to the CEAP classification and consecutively underwent duplex ultrasonography between April 2017 and December 2020.
Results: There were 362 limbs in male patients and 1,024 limbs in female patients. The limbs were classified as C0s?C1 (608 limbs, 43.8%), C2 (727 limbs, 52.5%), or C3?C6 (51 limbs, 3.7%). The prevalence of saphenous vein incompetence in CEAP C0s?C1 limbs was 43.6%. The saphenofemoral junction (SFJ) was competent in 37% of CEAP C2?C6 limbs. The CEAP C3?C6 category was not correlated with reflux patterns of the saphenous vein system (Cramer’s V=0.07), incompetent SFJ (Cramer’s V=0.07), deep vein reflux (Cramer’s V=0.03), or the distribution of incompetent segments in the great saphenous vein (GSV) (Cramer’s V=0.11).
Conclusion: Duplex ultrasonography is necessary to formulate a proper treatment plan for limbs categorized as CEAP C0s?C1. The SFJ was competent in more than one-third of CEAP C2?C6 limbs with GSV reflux; as such, flush ligation of the GSV may be unnecessary in these patients. The CEAP C3?C6 category showed no correlations with reflux patterns of the saphenous vein system, SFJ reflux, deep vein reflux, or the distribution of incompetent segments in the GSV.

Keywords: Duplex ultrasonography, Venous insufficiency, Saphenous vein

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