Association between Insufficiency of Anterior Perforator Vein of the Knee and Great Saphenous Vein Insufficiency in Patients with Primary Varicose Veins of the Lower Limbs

M. V. Barros, Gabriela Silva Lauar, Jéssica Monteiro Machado, Maria Cláudia Freitas Silva, Taynara Andrade Capanema
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Abstract

Background: The accurate identification of reflux points in the study of primary varicose veins of the lower limbs is important in the therapeutic approach of these patients. Objective: To evaluate the association between insufficiency of the anterior perforator vein of the knee and great saphenous vein insufficiency in patients with primary varicose veins of the lower limbs. Methods: The study included 886 patients, corresponding to 1,772 lower limbs, in patients older than 18, of both sexes, undergoing superficial venous mapping using vascular ultrasound. Results: The mean age of the patients was 46.1 ± 14.5 and 81.7% were females. Great saphenous vein insufficiency was found in 38.8% of the cases. Insufficiency of the anterior perforator vein of the knee was found in 146 lower limbs (8.2%), with a mean diameter of 1.7 ± 0.15 mm, prevailing in the infrapatellar area (86.4%). The anterior tributary vein of the great saphenous vein originated leg reflux in 34%, with a direct relation of this tributary vein with the anterior perforator vein of the knee in 79.4%. An association between the presence of anterior perforator vein of the knee and great saphenous vein insufficiency (p = 0.0001) and male gender (p = 0.001). Conclusion: There was an association between insufficiency of the anterior perforator vein of the knee and great saphenous vein insufficiency in patients with primary varicose veins of the lower limbs at vascular ultrasound, and the accurate identification of this perforator vein may be important in the therapeutic approach of these patients. (Arq Bras Cardiol: Imagem cardiovasc. 2019;32(1):14-18)
原发性下肢静脉曲张患者膝关节前穿支静脉不全与大隐静脉不全的关系
背景:在下肢原发性静脉曲张的研究中,准确识别反流点对这些患者的治疗方法至关重要。目的:探讨原发性下肢静脉曲张患者膝关节前穿支静脉功能不全与大隐静脉功能不全的关系。方法:本研究纳入886例患者,对应1772条下肢,年龄大于18岁,男女均行血管超声浅静脉测图。结果:患者平均年龄为46.1±14.5岁,女性占81.7%。38.8%的病例发现大隐静脉功能不全。膝关节前穿支静脉不全146例(8.2%),平均直径1.7±0.15 mm,以髌下区多见(86.4%)。34%由大隐静脉的前支静脉引起腿返流,79.4%与该支静脉与膝关节前穿支静脉有直接关系。膝关节前穿支静脉和大隐静脉功能不全(p = 0.0001)与男性(p = 0.001)之间的关系。结论:下肢原发性静脉曲张患者的膝关节前穿支静脉不全与大隐静脉不全存在一定的相关性,准确识别该支静脉对患者的治疗有重要意义。(Arq Bras Cardiol:心血管成像。2019; 32 (1): 14 - 18)
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