A study of chronic superficial venous insufficiency in patients with competent saphenofemoral junction

Abstract

Background: Chronic venous insufficiency (CVI) is a condition that affects the venous system of the lower extremities rendering the superficial, perforating, and deep veins incompetent. This results in venous hypertension causing various pathologies including pain, swelling, edema, skin changes and ulcerations. Traditionally SFJ incompetence was viewed as the primary pathology for varicose veins and Trendelenburg’s surgery is considered as a standard surgical procedure for the treatment of varicose veins. Later studies have shown incidence of chronic superficial venous insufficiency (CSVI) with competent SFJ was seen in as many as about 40% cases. Therefore, present study aims to identify the incidence of CSVI with competent SFJ, severity of disease in these individuals and patient outcome and response to Trendelenburg’s surgery.Methods: Prospective observational study with non-randomised purposive sampling.Results: Prevalence of competent SFJ was about 40.54% in patient with CSVI. 56.7% patients had C4 disease, 26.7% had C6 disease, 13.3% had C5 disease and 3.3% had C2 disease. In all the patients, progression of the disease was arrested after surgical intervention and no recurrence or ulceration was seen by the end of the 3 months.Conclusions: In comparison to patients with CVI with incompetent SFJ, patient with CSVI. Competent SFJ vary in that there is high male preponderance compared to females, disease progression and severity is independent of age and gender. Surgical outcomes were comparable to the patients with CSVI and incompetent SFJ Trendelenburg surgery can be used as the choice of surgical treatment in patients with competent SFJ and CSVI.