Proximal Reflux Adversely Affects Distal Venous Function

In limbs with chronic venous insufficiency (CVI), the presence of popliteal vein reflux has correlated with severity of venous insufficiency. Correction of proximal deep venous reflux has improved clinical manifestations of CVI, but the hemodynamic results of doing so have been disappointing. The present study was done to ascertain the effects of proximal reflux upon distal vein function.A total of 226 patients (175 women, 51 men) entered this study. Venous insufficiency in each of 450 limbs was classified according to Joint Councils' recommendations, and reflux was assessed by a modification of a method of Nicolaides and of van Bemmelen. Reflux in the femoral vein (FV), greater saphenous vein (GSV), popliteal vein (PV), and lesser saphenous vein (LSV) of the nonweight-bearing limb was quantitated by using the ATL 9 duplex scanner with a 5 MHz probe during rapid distal pneumatic cuff deflation. Data obtained included vein diameter, reflux volume, and reflux peak velocity. Limbs with PV reflux with and wit...