Engelhorn Carlos Alberto, Engelhorn Ana Luiza V, Cassou Maria Fernanda, Salles-Cunha Sergio
Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
Dermatol Surg. 2007 Mar;33(3):282-8. doi: 10.1111/j.1524-4725.2007.33063.x.
Telangiectasias have been treated with sclerotherapy without concomitant assessment or treatment of saphenous veins.
To clarify if ultrasound (US) mapping of saphenous veins is justifiable, this investigation determined prevalence of specific patterns of saphenous vein reflux in women with telangiectasias.
US mapping of the great and small saphenous veins (GSV, SSV) was performed in 1,740 extremities of 910 consecutive patients, mostly women (86%). A subgroup of 269 limbs of women with telangiectasias (CEAP C1 class) was included in this study. Patterns of GSV and SSV reflux were classified as perijunctional, proximal, distal, segmental, multisegmental, and diffuse.
Reflux was detected in 125 extremities (46%): 5% had reflux in both the GSV and the SSV, 39% had GSV reflux, and 2% had SSV reflux. The most common pattern of GSV reflux was segmental (73%, 87/119). Prevalence of reflux was significantly greater in GSV versus SSV (p < .001). GSV segmental plus distal reflux (40%, 108/269) was significantly more prevalent than saphenofemoral junction or near junction reflux (4%, 11/269; p < .001).
US mapping of the GSV in women with telangiectasias is justifiable, even in asymptomatic extremities. Further research will determine if segmental reflux should be treated to avoid evolution to severe valvular insufficiency.
以往采用硬化疗法治疗毛细血管扩张症时，未同时对大隐静脉进行评估或治疗。
为明确对大隐静脉进行超声（US）检查是否合理，本研究确定了毛细血管扩张症女性患者大隐静脉反流的特定模式的患病率。
对910例连续患者（大多数为女性，占86%）的1740条肢体进行大隐静脉和小隐静脉（GSV、SSV）的超声检查。本研究纳入了269例患有毛细血管扩张症（CEAP C1级）女性的肢体亚组。GSV和SSV反流模式分为交界周、近端、远端、节段性、多节段性和弥漫性。
在125条肢体（46%）中检测到反流：5%的GSV和SSV均有反流，39%有GSV反流，2%有SSV反流。GSV反流最常见的模式是节段性（73%，87/119）。GSV反流的患病率显著高于SSV（p <.001）。GSV节段性加远端反流（40%，108/269）明显比隐股交界或交界附近反流（4%，11/269；p <.001）更常见。
对患有毛细血管扩张症的女性进行GSV超声检查是合理的，即使在无症状的肢体中也是如此。进一步的研究将确定节段性反流是否应进行治疗，以避免发展为严重的瓣膜功能不全。
