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• W2433004844 abstract "Focal dilatations of the saphenous trunk (ST) are defined as a dilated part of the ST with a maximal diameter that is 1.5 to three times the diameter of the ST above or below.1Labropoulos N. Kokkosis A. Spentzouris G. Gasparis A.P. Tassiopoulos A.K. The distribution and significance of varicosities in the saphenous trunks.J Vasc Surg. 2010; 51: 96-103Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar They are commonly reported in patients with great saphenous vein (GSV) reflux and seem to be associated with more advanced stages of chronic venous disease (CVD).1Labropoulos N. Kokkosis A. Spentzouris G. Gasparis A.P. Tassiopoulos A.K. The distribution and significance of varicosities in the saphenous trunks.J Vasc Surg. 2010; 51: 96-103Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar, 2Cavezzi A. Rosi C. Heyn R. Franceschini M. Acconcia M.C. Age-related variations of varicose veins anatomy.J Vasc Surg. 2006; 44: 1291-1295Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar Understanding the association between focal dilatations and clinical as well as hemodynamic findings may contribute to further unravelling the pathophysiology of CVD. In a cross-sectional cohort study, we investigated the distribution of focal dilatations and associated factors in limbs with primary GSV, anterior accessory saphenous vein (AASV), or small saphenous vein (SSV) reflux. The patients were recruited from the outpatient clinics of Dermatology (Erasmus MC, Rotterdam) and Angiology (Centre de Médecine Vasculaire, Grenoble) between March 2014 and May 2015. The local Medical Ethical Committee approved the protocol (MEC-2014-035). All patients who gave informed consent underwent a clinical examination, including the clinical class of the CEAP classification,3Cavezzi A. Labropoulos N. Partsch H. Ricci S. Caggiati A. Myers K. et al.Duplex ultrasound investigation of the veins in chronic venous disease of the lower legs–UIP consensus document. Part II. Anatomy.Eur J Vasc Endovasc Surg. 2006; 31: 288-299Abstract Full Text Full Text PDF PubMed Scopus (171) Google Scholar and duplex ultrasound scan4Eklöf B. Rutherford R.B. Bergan J.J. Carpentier P.H. Gloviczki P. Kistner R.L. et al.Revision of the CEAP classification for chronic venous disorders: consensus statement for the American Venous Forum International Ad Hoc Committee for Revision of the CEAP Classification, Helsingborg, Sweden.J Vasc Surg. 2004; 40: 1248-1252Abstract Full Text Full Text PDF PubMed Scopus (1506) Google Scholar was performed with the patient standing. Reflux was defined as retrograde flow during >0.5 second after calf compression. The presence and number of focal dilatations was registered. The GSV above knee level and the SSV were divided into three equal segments (proximal, middle, and distal third) to determine the location of the focal dilatation. A detailed description of the methods was presented previously.5van der Velden SK, De Maeseneer MG, Pichot O, Nijsten T, van den Bos RR. Postural diameter change of the saphenous trunk in chronic venous disease [published online ahead of print April 16, 2016]. Eur J Vasc Endovasc Surg doi: 10.1016/j.ejvs.2016.02.019.Google Scholar Univariable and multivariable logistic regression of the presence of one or more focal dilatations were used to test for associated factors, including gender, age, clinical class, diameter of the ST, and the presence or absence of reflux at the junction. We studied 193 limbs with reflux of the GSV (73%), SSV (15%), or AASV (12%). Median age was 59 years (interquartile range, 22-85), and 71% of the patients were women. Most of the included limbs were classified as C2 to C3 (71%). One or more focal dilatations were present in 68 limbs (35%). Two or three focal dilatations in a refluxing ST were less common than one and were only reported in 9% and 4%, respectively, of the study population. Focal dilatations were more often localized in the GSV (43%) than in the SSV (17%) or AASV (5%). In STs with one or more focal dilatations, the dilatation was significantly more often located in the proximal (59%) than in the distal (40%) or middle segment (1%) of the ST (P < .001). Of the five included variables, only the diameter of the ST and presence of reflux at the junction were independently associated with the presence of one or more focal dilatations, resulting in a R2 of 0.21 (Table).TableUnivariable and multivariable logistic regression analysis of presence of one or more focal dilatationsVariableUnivariable OR95% CIMultivariable OR95% CIAge in years <501.0– 50-650.70.3-1.5 >650.80.4-1.7Gender Females1.0––– Males0.80.4-1.5––Clinical class C0-C11.0––– C2-C31.80.7-4.9–– C4-C61.80.6-5.5––Junction reflux Yes1.0–1.0– No0.20.1-0.40.30.1-0.7Diameter1.51.3-1.81.41.1-1.7CI, Confidence interval; OR, odds ratio. Open table in a new tab CI, Confidence interval; OR, odds ratio. Our results confirm that focal dilatations are frequently observed in patients with ST reflux and are associated with junctional reflux and a large saphenous diameter. This demonstrates that the presence of one or more focal dilatations is correlated to hemodynamic abnormalities of the refluxing ST. When management strategies in patients with varicose veins are being considered,6van der Velden S.K. Pichot O. van den Bos R.R. Nijsten T.E. De Maeseneer M.G. Management strategies for patients with varicose veins (C2-C6): results of a worldwide survey.Eur J Vasc Endovasc Surg. 2015; 49: 213-220Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar it should be further investigated whether the presence in C2 to C3 limbs of one or more focal dilatations, in addition to presence of junctional reflux and a large saphenous diameter, may be an argument for ablation of the refluxing ST rather than its conservation." @default.
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• W2433004844 title "Focal dilatation of the saphenous trunk in chronic venous disease" @default.
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