A Study of Valvular Incompetencies in the Lower Limb Veins Using Doppler Ultrasound Findings

Sangeetha Arumugam; Durgavajjala Pragnya Manaswini; Prudhvinath A Reddy; Joy A Ghoshal; Nandha Kumar Subbiah

doi:10.7759/cureus.53765

A Study of Valvular Incompetencies in the Lower Limb Veins Using Doppler Ultrasound Findings

Cureus. 2024 Feb 7;16(2):e53765. doi: 10.7759/cureus.53765. eCollection 2024 Feb.

Authors

Sangeetha Arumugam¹, Durgavajjala Pragnya Manaswini¹, Prudhvinath A Reddy², Joy A Ghoshal¹, Nandha Kumar Subbiah¹

Affiliations

¹ Department of Anatomy, All India Institute of Medical Sciences, Mangalagiri, IND.
² Department of Radiology, All India Institute of Medical Sciences, Mangalagiri, IND.

Abstract

Introduction: Varicose veins (VV) are one of the most common pathologies associated with the venous system of the lower limb. In the Indian population, its incidence is higher, and it is one of the most commonly encountered cases in the hospital. The study aimed to note the widely affected anatomical structure in male and female varicose patients using Doppler ultrasound (DU) examination findings.

Methods: A total of 200 Doppler ultrasound reports of varicose patients were retrospectively analyzed and categorized based on the affected structure. The demographic data of all cases, such as age, sex, brief history, signs, symptoms, and affected side of the lower limb, was noted. Anatomical structures causing venous refluxes in the saphenous systems, junctions, and perforating venous systems were noted. Pearson's correlation coefficient was applied to find out its association.

Results: Out of 200 Doppler reports studied, 133 (67%) were male and 67 (33%) were female patients. The majority, 180 (90%) cases, belonged to C1-C3 stages according to the Clinical, Etiology, Anatomy, and Pathological (CEAP) classification, while 20 (10%) were in C4-C5 stages. Male patients aged between 31 and 40 years were predominantly affected, with their left side being affected most commonly. In female patients, the older age group of 50-60 years was predominantly affected. Great saphenous reflux in the groin due to incompetent terminal valve was noted in 126 (63%) cases. In the perforator venous (PV) system, defects in the medial leg perforator (189 (95%)), posterior leg (92 (46%)), and thigh perforator (20 (10%)) were noted.

Conclusion: In the present study, the occurrence of varicose veins is due to the involvement of superficial, deep, and perforator veins with varying percentages. Among the structures, the medial leg perforator was predominantly involved, followed by other perforators. Since most patients were in C1-C3 stages, the involvement of deep veins was noted minimally.

Keywords: great and short saphenous veins; perforator veins; varicose; venous anatomy; venous duplex ultrasound.