Year 2013 Vol. 21 No 1

GENERAL AND SPECIAL SURGERY

E.P. BURLEVA 1, S.A. TYRIN 2, R.R. FASKHIEV 2

CLINICAL AND ULTRASOUND COMPARISON IN THE GREAT SAPHENOUS VEIN SYSTEM AT VENOUS DISEASE

SBEE HPE Ural State Medical Academy1,
MAE City Clinical Hospital 40 2, Yekaterinburg,
The Russian Federation

Objectives. To perform the comparison of clinical and ultrasonic examination in the assessment of varicose veins of the lower limbs in the great saphenous vein system.
Methods. 102 patients (102 limbs) with varicose veins of lower limbs (VVLL) of C 2-6 classes of chronic venous disease (CVD) were examined. The patients were subdivided into 4 groups: the 1st group ( 2, 3) 30 patients, the 2nd ( 4) 34, the 3rd (C5) 22, the 4th (C6) 16.
At the ultrasound investigation the trunk diameters (D) of the large saphenous vein (LSV) on the thigh were registered as well as the extent of the vertical pathological refluxes, the number of the incompetent perforating veins (PV) and their summarized diameter (∑ D).
Results. The average diameter of GSV in the 1st group was 7,2 0,2 mm, in the 2nd and 3rd groups 9,07 0,12 mm and 10,6 1,2 mm, in the 4th group 12,5 1,22 mm. In the 1st group the extended reflux prevailed - 76,7% , in the 2nd the subtotal one 58,8%, in the 3rd and 4th groups the total one 54,6% and 87,5%. The average number of the incompetent PV of the thigh and shin increased from 2,1 0,22 in the 1st group up to 4,8 0,13 in the 4th group (<0,05). The summarized diameter of PV between the 1st group 6,1 1,8 mm; the 2nd group 6,1 1,8 mm and the 3rd group 11,0 3,4 mm reliably differs (<0,05); there were no reliable differences between the 3rd and 4th groups 16,4 5,8 mm (>0,05).
Conclusions. At VVLL in the GSV system with the CVD class increase, D of the GSV trunk, the extent of the vertical pathological reflux, the number of PV and ∑ D of PV also increase.

Keywords: varicose veins, great saphenous vein, perforating veins, ultrasound angioscannings
p. 46 51 of the original issue
References
  1. Stoiko IuM, Lytkin MN, Shaidakov EV. Venoznaia gipertenziia v sisteme polykh ven [Venous hypertension in the system of hollow veins]. Saint-Petersburg: Rubin, RF; 2002. 276 p.
  2. Ramelet AA, Perrin M, Kern P, Bounameaux H. Phlebology. Elsevier Masson; 2008. p. 6170.
  3. Shaidakov EV, Iliukhin EA, Petukhov AV. Sravnenie khirurgicheskikh metodov likvidatsii vertikal'nogo refliuksa v klinicheskikh issledovaniiakh [Comparison of surgical methods of vertical reflux elimination in clinical trials]. Flebologiia. 2012;6(1): 3740.
  4. Zolotukhin IA, Karalkin AV, Iarich AN, Kirienko AV. Otsenka funktsii perforantnykh ven goleni pri varikoznoi bolezni s pomoshch'iu metodiki radionuklidnoi flebografii [Estimate of perforating veins function of limb varicose veins using the radionuclide phlebography technique]. Flebologiia. 2011;5(2):1417.
  5. Zolotukhin IA, Bogachev VIu, Kuznetsov AN, Kirienko AI. Nedostatochnost' perforantnykh ven goleni: kriterii i chastota vyiavleniia [Limb perforating veins failure: criteria and the detection rate]. Flebologiia. 2008;2(1):2126.
  6. Bello M, Scriven M, Hartshorne T, Bell PR, Naylor AR, London NJ. Role of superficial venous surgery in the treatment of venous ulceration. Br J Surg. 1999 Jun;86(6):75559.
  7. Zolotukhin IA, Karalkin AV, Iarich AN, Seliverstov EI, Kirienko AI. Otkaz ot dissektsii perforantnykh ven ne vliiaet na rezul'tat flebektomii u patsientov s varikoznoi bolezn'iu [Disclaimer from the dissection of perforating veins does not affect the phlebectomy outcome in patients with varicosity]. Flebologiia. 2012;6(3):1619.
  8. Fitridge RA, Dunlop C, Raptis S, Thompson MM, Leppard P, Quigley F. A prospective randomized trial evaluating the haemodynamic role of incompetent calf perforating veins. Aust N Z J Surg. 1999 Mar;69(3):21416.
  9. Danielsson G, Eklof B, Kistner RL. What is the role of incompetent perforator veins in chronic venous disease? Aust N Z J Surg. 2001;71(2):11416.
  10. Shval'b PG. Sistemnyi podkhod k patogenezu khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei [A systematic approach to the pathogenesis of chronic venous insufficiency of the lower limbs]. Angiologiia i Sosud Khirurgiia. 2002 8(3):3036.
  11. Coleridge-Smith P, Labropoulos N, Partsch H, Myers K, Nicolaides A, Cavezzi A. Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbsUIP consensus document. Part I. Basic principles. Eur J Vasc Endovasc Surg. 2006 Jan;31(1):8392. Review.
  12. Mdez-Herrero A, Gutierrez J, Camblor L, Carreno J, Llaneza J, Rguez-Olay J, Suarez E. The relation among the diameter of the great saphenous vein, clinical state and haemodynamic pattern of the saphenofemoral junction in chronic superficial venous insufficiency. Phlebology. 2007;22(5):20713.
  13. Zolotukhin IA, Bogachev VIu, Kirienko AI. Bol'shaia podkozhnaia vena: osobennosti ul'trazvukovoi anatomii i patologicheskogo refliuksa [Large subcutaneous vein: ultrasound features of anatomy and pathological reflux]. Grud i Serdech-Sosud Khirurgiia. 2006;(5):3942.
  14. Korovin AIa, Shumskaia VV, Andreev AV. Topicheskaia sonograficheskaia diagnostika varikoznoi bolezni [Topical sonographic diagnosis of varicose veins]. Ekhografiia. 2003;(2):19293.
  15. Shval'b PG, Ukhov IuI. Patologiia venoznogo vozvrata iz nizhnikh konechnostei [The pathology of venous return from the lower extremities]. Ryazan, RF: RiazGMU; 2009. 152 p.
  16. 16.Dumpe EP, Ukhov IuI, Shval'b PG. Fiziologiia i patologiia venoznogo krovoobrashcheniia nizhnikh konechnostei [Physiology and pathology of the venous circulation of the lower limbs]. Moscow, RF: Meditsina; 1982. 168 p.
  17. Sukovatykh BS, Sukovatykh MB, Belikov LN, Akatov AL. Sostoianie perforantnykh ven goleni posle sklerokhirurgicheskikh vmeshatel'stv po povodu bolezni nizhnikh konechnostei [Perforating veins state after sclerosurgical interventions for diseases of the lower extremities]. Angiologiia i Sosud Khirurgiia. 2012;(2): 8488.
Address for correspondence:
620102, Rossiiskaia Federatsiia, g. Ekaterinburg, ul. Volgogradskaia, d. 189, MAU Gorodskaia klinicheskaia bol'nitsa 40, kafedry obshchei khirurgii,
e-mail: burleva@gkb40.ur.ru,
Burleva Elena Pavlovna
Information about the authors:
Burleva E.P. MD, professor of the general surgery chair of SBEE HPE Ural State Medical Academy.
Tyrin S.A. Surgeon of the vascular surgery department of MAE City clinical hospital 40.
Fashiev R.R. Physician of the functional and ultrasound diagnostics of the functional diagnostics unit of MAE City clinical hospital 40.
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