Original Articles from the Eastern Vascular SocietyComparison of descending phlebography with quantitative photoplethysmography, air plethysmography, and duplex quantitative valve closure time in assessing deep venous reflux☆,☆☆
Section snippets
Patients
Patients were divided into three groups. Group N consisted of eight limbs in four normal healthy volunteers (three men and one woman; average age, 29.5 years). This group did not undergo ascending or descending phlebography. Group M consisted of those limbs that had mild (grade 0, 1, or 2) venous reflux as determined by descending phlebography (Table II).5Grade Degree of reflux 0 None 1 Minimal; reflux to most proximal valve in SFV 2 Mild; reflux to above
Results
Clinical stage by the Society for Vascular Surgery/International Society for Cardiovascular Surgery4 differed between those with mild phlebographic reflux and those with severe phlebographic reflux (Table III).Eight of 10 limbs in group S were clinical grade 3, whereas five of 10 limbs in group M were clinical grade 3. Incompetent perforating veins as defined by ascending phlebography were present in five of 10 limbs in group M and in six of 10 limbs in group S. The presence of incompetent
Discussion
Just as the severity of arterial insufficiency is manifested by the clinical condition—claudication, rest pain, and tissue loss—so is the severity of venous insufficiency—edema, pigmentation, liposclerosis, and ulceration. When the clinical condition as managed conservatively becomes intolerable to the patient, surgery should be considered. The decision to proceed with surgery may be aided by noninvasive tests. Invasive tests, however, provide the anatomic information crucial to selecting the
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Reprint requests: Thomas F. O'Donnell, Jr., MD, Box 259, 750 Washington St., Tufts-New England Medical Center, Boston, MA 02111.
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J Vasc Surg 1992;16:913–20.