Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity

PURPOSEThis study aims to establish a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency and to evaluate the relationship between this classification, the demographics, and severity of clinical findings.METHODSThis is a retrospective study fro...

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Main Authors: Sezen Yılmaz, Burçak Çakır Peköz, Neris Dincer, Sinan Deniz, Levent Oğuzkurt
Format: Article
Language:English
Published: Galenos Publishing House 2021-03-01
Series:Diagnostic and Interventional Radiology
Online Access: http://www.dirjournal.org/archives/archive-detail/article-preview/classification-of-reflux-patterns-in-patients-with/54473
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author Sezen Yılmaz
Burçak Çakır Peköz
Neris Dincer
Sinan Deniz
Levent Oğuzkurt
author_facet Sezen Yılmaz
Burçak Çakır Peköz
Neris Dincer
Sinan Deniz
Levent Oğuzkurt
author_sort Sezen Yılmaz
collection DOAJ
description PURPOSEThis study aims to establish a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency and to evaluate the relationship between this classification, the demographics, and severity of clinical findings.METHODSThis is a retrospective study from prospectively collected data of 503 patients who had the complaint of varicose vein. All patients had complete physical examination and their medical history was recorded. Lower limbs of all patients were examined with Doppler ultrasonography. A total of 787 limbs with great saphenous vein insufficiency were included in the analysis. The reflux patterns of great saphenous vein insufficiency were classified into 4 types as: type 1, great saphenous vein reflux without involvement of malleolar region and saphenofemoral junction (SFJ); type 2, reflux involving malleolar region with competent SFJ; type 3, reflux involving SFJ with competent malleolar region; and type 4, reflux involving both the SFJ and the malleolar region. We evaluated the association between the classification of great saphenous vein insufficiency and age, sex, body mass index (BMI), disease duration, clinical, etiological, anatomical and pathophysiological elements (CEAP) classification and venous clinical severity score (VCSS).RESULTSThe mean age of the patients was 45.3±11.7 years, with a male-to-female ratio of 2:3. The most common reflux pattern in patients with great saphenous vein insufficiency was type 3 (48.9%), while 14.8% of patients had type 1, 10.4% had type 2, and 25.7% had type 4. Patients with type I reflux pattern were younger in age (p = 0.002), had lower BMI (p = 0.002), fewer number of children (p = 0.008), as well as milder clinical severity score (p = 0.002) compared to other reflux types. Duration of disease symptoms was not significantly correlated with the reflux patterns, but VCSS increased with the involvement of malleolar region as in type 2 compared to type 1 (2.82±1.67 vs. 2.74±2.31), and further increased with the involvement of SFJ as in type 3 (4.13±2.92 vs. 2.82±1.67). Patients with diffuse reflux pattern (type 4) had the most severe clinical presentation (4.59±2.9).CONCLUSIONWe developed a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency based on the involvement of malleolar region and/or SFJ. We showed an association between weight, BMI, VCSS, CEAP classification and the extent of insufficiency.
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spelling doaj.art-a7d5e148be864d60bbe5c520297023922023-09-06T12:22:37ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122021-03-0127221922410.5152/dir.2021.1958013049054Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severitySezen Yılmaz0Burçak Çakır Peköz1Neris Dincer2Sinan Deniz3Levent Oğuzkurt4 School of Medicine,Koç University, Istanbul, Turkey University of Health Sciences, Adana Health Practices and Research Center, Adana, Turkey School of Medicine,Koç University, Istanbul, Turkey Department of Diagnostic and Interventional Radiology, Koç University Hospital, Istanbul, Turkey Department of Diagnostic and Interventional Radiology, Koç University Hospital, Istanbul, Turkey PURPOSEThis study aims to establish a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency and to evaluate the relationship between this classification, the demographics, and severity of clinical findings.METHODSThis is a retrospective study from prospectively collected data of 503 patients who had the complaint of varicose vein. All patients had complete physical examination and their medical history was recorded. Lower limbs of all patients were examined with Doppler ultrasonography. A total of 787 limbs with great saphenous vein insufficiency were included in the analysis. The reflux patterns of great saphenous vein insufficiency were classified into 4 types as: type 1, great saphenous vein reflux without involvement of malleolar region and saphenofemoral junction (SFJ); type 2, reflux involving malleolar region with competent SFJ; type 3, reflux involving SFJ with competent malleolar region; and type 4, reflux involving both the SFJ and the malleolar region. We evaluated the association between the classification of great saphenous vein insufficiency and age, sex, body mass index (BMI), disease duration, clinical, etiological, anatomical and pathophysiological elements (CEAP) classification and venous clinical severity score (VCSS).RESULTSThe mean age of the patients was 45.3±11.7 years, with a male-to-female ratio of 2:3. The most common reflux pattern in patients with great saphenous vein insufficiency was type 3 (48.9%), while 14.8% of patients had type 1, 10.4% had type 2, and 25.7% had type 4. Patients with type I reflux pattern were younger in age (p = 0.002), had lower BMI (p = 0.002), fewer number of children (p = 0.008), as well as milder clinical severity score (p = 0.002) compared to other reflux types. Duration of disease symptoms was not significantly correlated with the reflux patterns, but VCSS increased with the involvement of malleolar region as in type 2 compared to type 1 (2.82±1.67 vs. 2.74±2.31), and further increased with the involvement of SFJ as in type 3 (4.13±2.92 vs. 2.82±1.67). Patients with diffuse reflux pattern (type 4) had the most severe clinical presentation (4.59±2.9).CONCLUSIONWe developed a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency based on the involvement of malleolar region and/or SFJ. We showed an association between weight, BMI, VCSS, CEAP classification and the extent of insufficiency. http://www.dirjournal.org/archives/archive-detail/article-preview/classification-of-reflux-patterns-in-patients-with/54473
spellingShingle Sezen Yılmaz
Burçak Çakır Peköz
Neris Dincer
Sinan Deniz
Levent Oğuzkurt
Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
Diagnostic and Interventional Radiology
title Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
title_full Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
title_fullStr Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
title_full_unstemmed Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
title_short Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
title_sort classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
url http://www.dirjournal.org/archives/archive-detail/article-preview/classification-of-reflux-patterns-in-patients-with/54473
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AT nerisdincer classificationofrefluxpatternsinpatientswithgreatsaphenousveininsufficiencyandcorrelationwithclinicalseverity
AT sinandeniz classificationofrefluxpatternsinpatientswithgreatsaphenousveininsufficiencyandcorrelationwithclinicalseverity
AT leventoguzkurt classificationofrefluxpatternsinpatientswithgreatsaphenousveininsufficiencyandcorrelationwithclinicalseverity