Does a Varicose Saphenous Vein Exist?

Abstract

Objective:

Duplex ultrasound evaluation of the clinically diagnosed varicose long saphenous vein (LSV).

Design:

Prospective, single patient group study.

Setting:

Department of Surgery, University of Ferrara, Italy (teaching hospital).

Patients:

378 patients, 509 limbs with primary varicose veins; 94 patients, 103 limbs with a visible, superficial varicose vein trunk on the medial aspect of the thigh.

Main outcome measure:

Duplex ultrasound detection of a varicose saphenous vein and/or segmental saphenous dilatation and their relationship to saphenous reflux.

Results:

In 98% of cases the varicose trunk visible in the thigh was demonstrated to be a tributary of the saphenous vein; 34% of the observed saphenous veins exhibited segmental dilatations in the thigh. This finding was related in every case to saphenous vein reflux with high velocity and turbulence (p < 0.0001).

Conclusions:

High-resolution ultrasonography demonstrated that when a dilated varicose longitudinal vein trunk is visible and palpable on the medial aspect of the thigh it is most likely to be a tributary rather than the LSV. In addition, a varicose saphenous vein along its entire length essentially does not exist. However, when a dilated saphenous segment occurs, it seems to be related to high diastolic flow velocity and turbulence.