Katsamouris A N, Kardoulas D G, Gourtsoyiannis N
Vascular Surgical Unit, University of Crete Medical School, Herakleion University Hospital, Greece.
Eur J Vasc Surg. 1994 Jul;8(4):464-71. doi: 10.1016/s0950-821x(05)80966-1.
The purpose of this study was to investigate the distribution of vein incompetence and the nature of venous haemodynamics accompanying the development of lower extremity primary varicose veins (LEPVV). The entire venous circulation of 77 lower extremities in 55 patients (pts) with LEPVV was evaluated, by using Duplex colour Doppler ultrasonography. The greater and lesser saphenous veins (GSV, LSV) and their branches were thoroughly scanned. The valvular integrity of the deep venous system was determined in the areas of common and superficial femoral vein, saphenofemoral junction, popliteal vein, saphenopopliteal junction, and perforating veins. Demonstration of bidirectional flow signified venous incompetence. Quantitation of venous reflux was estimated after manual calf compression with pts in a standing position. All the symptomatic legs had branch venous disease, 60% had GSV incompetence, 3% had LSV incompetence, 10% showed concurrent GSV and LSV incompetence, while 27% demonstrated no evidence of GSV, and LSV disease. Thirty per cent and 50% of the symptomatic legs demonstrated deep and perforating vein incompetence, respectively. Furthermore, 30% of the asymptomatic lower extremities had insufficiency of saphenofemoral (nine pts) and saphenopopliteal (one pt) junction. The median peak venous reflux in the incompetent GSV and popliteal vein was 0.74 ml/s (range 0.2 to 2.5 ml/s) and 3.5 ml/s (range 2.5 to 8 ml/s), respectively. In conclusion, the observed heterogeneity in anatomic and functional distribution of lower extremity venous insufficiency in pts with LEPVV support the hypothesis that this condition is probably a part of another entity that might be called "lower extremity primary venous insufficiency" whose treatment should be highly individualised. To this end, colour Doppler imaging can help.
本研究的目的是调查下肢原发性静脉曲张（LEPVV）发展过程中静脉功能不全的分布情况以及静脉血流动力学的性质。采用双功彩色多普勒超声对55例LEPVV患者的77条下肢的整个静脉循环进行了评估。对大隐静脉和小隐静脉（GSV、LSV）及其分支进行了全面扫描。在股总静脉、股浅静脉、隐股静脉交界处、腘静脉、隐腘静脉交界处和穿通静脉区域测定深静脉系统的瓣膜完整性。双向血流的显示表明静脉功能不全。在患者站立位进行小腿手法加压后估计静脉反流的定量。所有有症状的下肢均有分支静脉疾病，60%有GSV功能不全，3%有LSV功能不全，10%同时存在GSV和LSV功能不全，而27%未显示GSV和LSV疾病的证据。有症状的下肢分别有30%和50%显示深静脉和穿通静脉功能不全。此外，30%的无症状下肢有隐股静脉（9例）和隐腘静脉（1例）交界处功能不全。功能不全的GSV和腘静脉的静脉反流峰值中位数分别为0.74 ml/s（范围为0.2至2.5 ml/s）和3.5 ml/s（范围为2.5至8 ml/s）。总之，LEPVV患者下肢静脉功能不全在解剖和功能分布上观察到的异质性支持了这样一种假设，即这种情况可能是另一种实体的一部分，可以称为“下肢原发性静脉功能不全”，其治疗应高度个体化。为此目的，彩色多普勒成像会有所帮助。
