Varicose veins in lower limbs. Doppler ultrasound: venous reflux classification and surgical treatment management

Abstract

The authors mention the possibilities of venous doppler ultrasound examination with color in the study of varicose veins of the lower limbs.
They describe the methodology of the test according to the consensus document of the International Union of Phlebology and, based on extensive clinical practice, present a protocol of venous ecodoppler examination.

They analyze relevant evidences of ecodoppler venous examination which have been the basis of a new concept of beginning and evolution of varicose veins of the lower limbs, a concept of centripetal start from the outside in, from colateral to saphenous veins and upward trend in opposition to classical concept of centrifugal start from the inside out, saphenous veins to colaterals and downward trend. 

he survey results echo-Doppler venous have also been the basis of descriptive different types of venous reflux culminating in a simplified classification of two major types of venous reflux: the axial and segmental reflux. This classification, which begins to be used in reports of examinations, results relevant in surgery of varicose veins of the possibility of side phlebectomies varicose vein reflux in the great saphenous segment preserving, thus avoiding crossectomy and «stripping» and reserving surgery classic for varicose veins with axial reflux. This strategy of surgical treatment has been shown in clinical follow-up and echo - Doppler results equal to or better than a standardized surgical treatment strategy.

Keywords: lower limb varicose veins, venous varicose Doppler ultrasound with color