ÖZHAN ÖZGÜR, Emel ALİMOĞLU, Kağan ÇEKEN, Ali APAYDIN, HAKKI TİMUR SİNDEL

Chronic venous insufficiency patterns in lower extremity veins detected by Doppler Ultrasound

Amaç: Bu çalışmada, varis şikayeti olan hastalarda Doppler US ile alt ekstremite de tespit edilen kronik venöz yetmezliğinin paternlerinin ve klinik öneminin ortaya konması amaçlanmıştır. Yöntemler: Venöz yetmezlik semptomu olan 2006 hasta çalışmaya dahil edilmiştir.Doppler US inceleme yapılan toplam 3938 alt ekstremite venöz sistemi incelenmiştir. Araştırmada yüzeyel ve derin venöz yetmezlik kombinasyonu gösteren dört patern klasifiye edilmiştir. Sonuçlar: İnceleme yapılan 2006 hastanın, 966sında ya tek venöz yetmezlik seviyesi (790, %82) ya da yetmezlik kombinasyonu (176, %18) saptanmıştır. Yüzeyel venöz yetmezlik, %57,6 Vena Safena Manga (VSM), %25,5 safenofemoral bileşke (SFB), %9,1 Vena Safena Parva (VSP), %2,4 Giacomini Veni, %1,8 safenopopliteal bileş- ke (SPB) seviyesinde karşımıza çıkmıştır. Yetmezlik gösteren hastalar arasında %51 oranında çoklu seviye yetmezlik kombinasyonları saptanmıştır. Bu kombinasyonlar dört patern olarak açıklanmıştır. Patern 1: SFB ile VSM (%97,9), VSMnın dallarının (%7,1) ve perforan venlerin (%20,8) birlikteliği. Patern 2: Derin venöz yetmezliğin, SFB (%63,6), VSM (%76,4), ve VSP (%16,4) ile kombinasyonu. Patern 3: SPB yetmezliğinin VSP (%95,5) ile birlikteliği. Patern 4: Giacomini Ven yetmekliğinin VSM (%67,9) ve VSP (%75) ile kombinasyonu. Tartışma: Kronik venöz yetmezlik dört patern olarak kar- şımıza çıkabilir. Sonuçlarımız özellikle SFB ile VSM ve derin venöz sistem ile VSM yetmezlik birlikteliğinin çok sık olduğunu ortaya koymaktadır.

Alt ekstremitede Doppler ultrasonografi ile tespit edilen kronik venöz yetmezlik tipleri

Objective: The aim of this study was to reveal patterns of chronic venous insufficiency of lower extremity detected by color Doppler ultrasound and clarify its clinical implications in the patients with varicose veins symptoms. Methods: Between 2006 to 2011, a total of 2006 patients presented with symptoms of venous insufficiency were included in study. A total of 3938 lower extremity venous systems were examined using color Doppler US. We classified four patterns considering combinations of superficial and deep venous insufficiency. Results: Of 2006 patients, 966 had either single venous insufficiency (790, 82%) or combined insufficiency (176, 18%). Superficial venous insufficiency was observed at the saphenoefemoral junction (SFJ) in 25.5%, at the Great Saphenous Vein (GSV) in 57.6%, at the Giacomini Vein in 2.4%, at the saphenopopliteal junction in 1.8% and finally at the Small Saphenous Vein (SSV) in 9.1% of the patients. We found multilevel venous insufficiency showing connections at the rate of 51%. We described four patterns as Pattern 1: SFJ insufficiency combined with GSV (97.9%), GSV branching (7.1%), and perforating vein (20.8%) insufficiency, Pattern 2: Deep venous insufficiency combined with SFJ (63.6%), GSV (76.4%), and SSV (16.4%) insufficiency, Pattern 3: SPJ insufficiency combined with SSV insufficiency (95.5%) and Pattern 4: Giacomini Vein insufficiency combined with GSV (67.9%) and SSV (75%) insufficiency. Conclusion: Chronic venous insufficiency may show four different patterns. Our results revealed that SFJ and GSV insufficiency combination and deep venous insufficiency and GSV insufficiency combinations are the most common insufficiency patterns seen in lower extremity.

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