Development of primary superficial venous insufficiency: the ascending theory. Observational and hemodynamic data from a 9-year experience

Annals of Vascular Surgery
Eugenio BernardiniRoberto Bisacci

Abstract

Hemodynamic principles suggest that primary venous insufficiency follows the hydrostatic column of venous pressure of the limbs, and therefore, venous reflux begins at the lower points and rises upwards. To test the hypothesis of an "ascending development" of reflux, we carried an observational study to analyze the natural evolution of lower limb venous insufficiency. During 9-year period patients with primary superficial venous disease who refused treatment were followed prospectively with 6-month scheduled clinical and duplex ultrasound examinations. Localization, stage, and evolution of the venous patterns were compared. A total of 104 limbs in 99 patients were analyzed (12 males, 92 female; mean age 48.7 years). Prevalence of reflux was (p < 0.001) more frequent along great-saphenous and its tributaries (78/104, 75%) than nonsaphenous veins. The time of re-examination ranged from 1 to 13 years (mean 4 +/- 3.1 years). With the exception of six remaining stable, all the veins showed a progression of insufficiency (94%); 47 involved deep circulation. In all the worsened refluxes, an extension to reach one or more venous segments at an upper level, uninvolved before, was found. There was no downward oriented pattern of progress...Continue Reading

References

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Citations

Feb 27, 2016·Clinical Imaging·Benjamin L YamNeil M Khilnani
May 19, 2012·Seminars in Vascular Surgery·Eric Mowatt-Larssen, Cynthia K Shortell
Apr 30, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·C WittensUNKNOWN European Society for Vascular Surgery
Sep 16, 2011·Journal of Vascular Surgery·Jordan R VincentAndre M van Rij
Nov 12, 2015·Phlebology·Sarah Onida, Alun H Davies
Jul 1, 2011·Vascular and Endovascular Surgery·Paul J RiesenmanKarthikeshwar Kasirajan
Mar 3, 2015·Phlebology·F Pannier, E Rabe
Mar 27, 2013·Phlebology·R D Malgor, N Labropoulos
Jun 21, 2017·Biomechanics and Modeling in Mechanobiology·Hsiao-Ying Shadow Huang, Jiaqi Lu
Nov 30, 2018·British Journal of Haematology·Matthew K H TanAlun H Davies
Dec 13, 2019·Phlebology·Felipe Coelho NetoWalter Junior Boim de Araujo
Jun 4, 2020·Cardiology and Therapy·Fedor Lurie
Dec 19, 2020·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Roman A TauraginskiiRishal Agalarov
Jul 21, 2021·International Angiology : a Journal of the International Union of Angiology·Fatima Z CyrinoEliete Bouskela

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