Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202200192
Jornal Vascular Brasileiro
Artigo Original

Patterns of flow drainage from varicose veins originating in the incompetent great saphenous vein

Padrões de drenagem do fluxo das varizes oriundas da veia safena magna incompetente

Felipe Coelho Neto; Maria Isabel Sarti Benatti; Mariana Cavalaro Ricciardi; Nicole Dorneli de Carvalho; Sergio Quilici Belczak; Walter Júnior Boim de Araújo; Rodrigo Gomes de Oliveira

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Abstract

Abstract: Background: Chronic venous insufficiency affects the lives of many people and therefore constitutes a public health problem. Knowledge of the drainage patterns of reflux from varicose veins secondary to incompetent saphenous veins is essential to define the best therapeutic management.

Objectives: To determine the reflux drainage patterns from varicose veins originating in incompetent GSV, the prevalence of perforating veins (PV), and their relationships with symptoms.

Methods: 55 ultrasound reports were analyzed to determine the drainage patterns of reflux from the GSV, location and diameter of PV drainage, and staging of symptoms.

Results: In 64% of the sample, reflux from varicose veins drained to PVs, in 4% reflux drained to the GSV itself, in another 4% drainage was to the small saphenous vein, and in 29% drainage was to varicose trunk veins in which no direct communication with the deep system could be identified. No associations were observed between symptoms and reflux drainage patterns or PV diameters.

Conclusions: For this sample, PVs were responsible for draining flow from varicose veins in 64% of cases. Neither PV diameters nor GSV reflux patterns were associated with severity of symptoms.

Keywords

varicose veins, saphenous vein, venous insufficiency, ultrasonography

Resumo

Resumo: Introdução: A insuficiência venosa crônica impacta a vida de muitas pessoas, constituindo-se, assim, como um problema de saúde pública. Conhecer o padrão de drenagem do refluxo das varizes associadas à veia safena incompetente é fundamental para definir a melhor programação terapêutica.

Objetivos: Determinar os padrões de drenagem do refluxo de varizes originadas da veia safena magna incompetente, a prevalência de veias perfurantes e a relação com os sintomas.

Métodos: Foram analisados 55 registros ultrassonográficos de pacientes com refluxo da veia safena magna para determinar padrões de drenagem do refluxo dessa veia, pontos de refluxo das varizes, localização e diâmetro das perfurantes de drenagem e graduação dos sintomas.

Resultados: O principal padrão de refluxo encontrado foi originado da junção safenofemoral com comprometimento proximal da veia safena magna. Em 64% dos pacientes, o refluxo das varizes drenou para veias perfurantes - 4% drenavam para a própria veia safena magna; em outros 4%, a drenagem era para a veia safena parva; e, em 29%, a drenavam destinava-se para varizes tronculares em que não se identificou comunicação direta com o sistema venoso profundo. Não foi observada associação dos sintomas com os padrões de drenagem do refluxo ou diâmetro das perfurantes.

Conclusão: Para essa amostra, as veias perfurantes foram responsáveis pelo escoamento do fluxo oriundo das varizes em 64% dos casos. O diâmetro das veias perfurantes e o padrão de refluxo da veia safena não estiveram associados à gravidade dos sintomas.
 

Palavras-chave

varizes, veia safena, insuficiência venosa, ultrassonografia

Referências

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Submetido em:
25/02/2022

Aceito em:
27/06/2023

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