Department of Ultrasound, Xijing Hospital, Xi'an, China.
University of California, Davis, Vascular Center, Sacramento, CA.
J Vasc Surg Venous Lymphat Disord. 2022 Nov;10(6):1201-1207.e2. doi: 10.1016/j.jvsv.2022.05.007. Epub 2022 Jul 8.
Hemodynamic changes in C to C according to the clinical/etiological/anatomical/pathophysiological classification have not been analyzed extensively. We intend to investigate the characteristics of early stage venous disease using venous clinical severity score (VCSS), heaviness/ache/swelling/throbbing/itching (HASTI) score and duplex ultrasound (DUS) derived parameters.
From Aug. 2020 to Jul. 2021, consecutive patients were categorized according to the clinical/etiological/anatomical/pathophysiological 2020 classification. The vein diameter (mm), reflux time (s), cross-sectional area (cm), peak and mean reflux velocity (cm/s), and total reflux volume (mL) were documented in the superficial system and deep system. VCSS and HASTI scores were assessed and DUS parameters were analyzed. A P value of less than .05 was considered statistically significant.
We studied 257 consecutive patients (142 female) with 371 limbs. The mean age was 50.96 ± 13.27 years (range, 20-81 years; median, 53 years) with an average body mass index of 24.03 ± 2.96 kg/m (range, 17.00-33.06 kg/m; median, 23.67 kg/m). The proportion of clinical (C) category was as followed: 47 C (12.67%), 45 C (12.13%), and 279 C (75.20%). There were 42.6% of C and 62.2% of C associated with some form of venous reflux, Pr (pathology [P]-reflux). Reflux of the great saphenous vein above the knee (GSVa) was the most commonly affected vein segment from C. C differed from C only by age and severity scores with a cut-off value of 1 for both VCSS and HASTI. Larger saphenous veins diameter (GSV and small saphenous vein) were seen in Pr (P-reflux) than Pn (P-none) of C cases. Larger deep vein diameters (common femoral vein, femoral vein, and popliteal vein) were evident in Pr versus Pn of C cases. In C, the popliteal vein, saphenofemoral junction, and GSVa were dilated in Pr cases.
Both HASTI and VCSS were discriminative from C to C. C differed from C by age and severity scores as DUS characteristics were not significantly different between the two groups. Vessel diameter played a discriminative role in distinguishing Pn versus Pr cases in each C category. GSVa was the most frequent reflux segment irrespective of reflux types.
根据临床/病因/解剖/病理生理学分类，C 至 C 期间的血液动力学变化尚未得到广泛分析。我们旨在使用静脉临床严重程度评分（VCSS）、沉重/疼痛/肿胀/悸动/瘙痒（HASTI）评分和双功能超声（DUS）得出的参数来研究早期静脉疾病的特征。
从 2020 年 8 月至 2021 年 7 月，连续患者根据临床/病因/解剖/病理生理学 2020 分类进行分类。在浅系统和深系统中记录静脉直径（mm）、反流时间（s）、横截面积（cm）、峰值和平均反流速度（cm/s）和总反流量（mL）。评估 VCSS 和 HASTI 评分并分析 DUS 参数。P 值小于 0.05 被认为具有统计学意义。
我们研究了 257 例连续患者（142 例女性），共 371 条肢体。平均年龄为 50.96±13.27 岁（范围，20-81 岁；中位数，53 岁），平均体重指数为 24.03±2.96kg/m（范围，17.00-33.06kg/m；中位数，23.67kg/m）。临床（C）类别比例如下：47 C（12.67%）、45 C（12.13%）和 279 C（75.20%）。C 中有 42.6%和 C 中有 62.2%与某种形式的静脉反流有关，Pr（病理学[P]-反流）。最常见的受累静脉节段是 C 中的膝关节以上大隐静脉（GSVa）反流。C 与 C 仅在年龄和严重程度评分上有所不同，两者的 VCSS 和 HASTI 截断值均为 1。与 C 中的 Pn（无 P 反流）相比，Pr（有 P 反流）中的大隐静脉（GSV）和小隐静脉直径更大。与 C 中的 Pn（无 P 反流）相比，Pr（有 P 反流）中的大隐静脉、股总静脉、股静脉和腘静脉直径更大。在 C 中，与 Pn（无 P 反流）相比，Pr（有 P 反流）中的腘静脉、隐股静脉交界处和 GSVa 扩张。
HASTI 和 VCSS 均能区分 C 与 C。C 与 C 的区别在于年龄和严重程度评分，因为两组之间的 DUS 特征没有显著差异。在每个 C 类别中，血管直径在区分 Pn 与 Pr 病例方面起决定性作用。GSVa 是最常见的反流节段，无论反流类型如何。
