Blood Flow Analysis of the Great Saphenous Vein in the Su-Pine Position in Clinical Manifestations of Varicose Veins of Different Severities: Application of Phase-Contrast Magnetic Resonance Imaging Data.

Yuan-Hsi Tseng,Yao-Kuang Huang,Bor-Shyh Lin,Yu-Hui Lin,Min-Yi Wong,Teng-Yao Yang,Chien-Wei Chen

doi:10.3390/diagnostics12010118

Abstract

The progression of clinical manifestations of lower-limb varicose veins remains unclear. This study investigated changes in lower-limb venous blood flow using phase-contrast magnetic resonance angiography. Data were collected on veins from 141 legs. We compared legs with and without varicose veins and related symptoms and examined varying levels of varicose vein symptom severity. Legs without varicose veins exhibited a lower absolute stroke volume (ASV, p < 0.01) and mean flux (MF, p = 0.03) for the great saphenous vein (GSV) compared with legs with symptomatic varicose veins. Legs with asymptomatic varicose veins exhibited lower MF for the GSV (p = 0.02) compared with legs with symptomatic varicose veins. Among legs with varicose veins, asymptomatic legs exhibited lower ASV (p = 0.03) and MF (p = 0.046) for the GSV compared with legs that exhibited skin changes or ulcers; however, no significant differences were observed between legs presenting with discomfort or edema and legs with skin changes or ulcers, and between legs presenting with discomfort or edema and asymptomatic legs. In conclusion, in the supine position, increased blood flow rate and blood flow volume in the GSV were associated with symptomatic varicose veins and increased symptom severity.

Highlights

Lower-limb varicose veins are typically related to chronic venous insufficiency and pathologic changes to the venous walls [1,2] and can cause various symptoms, including aesthetic problems, lower-limb discomfort, edema, skin changes, ulcers, chronic wounds, and lymphedema [3,4,5]
The patient is required to maintain a supine position during MRA scans, which can influence the accuracy of estimations for venous reflux by removing the ability to evaluate the influence of gravitational forces on lower-limb venous reflux
The abnormal venous anatomies found in the phase-contrast magnetic resonance angiography (PC-MRA) were collected, and included compression of the iliocaval territory, deep vein thrombosis, dilatation of the great saphenous vein (GSV; dilation was defined as a vein diameter > 3 mm), in addition to the GSV to popliteal vein (PV) diameter ratio

Summary

Introduction

Lower-limb varicose veins are typically related to chronic venous insufficiency and pathologic changes to the venous walls [1,2] and can cause various symptoms, including aesthetic problems, lower-limb discomfort (such as heaviness, aching or throbbing pain, cramping, and burning sensations), edema, skin changes, ulcers, chronic wounds, and lymphedema [3,4,5]. The severity of venous reflux does not correlate entirely with the severity of clinical manifestations, which can be influenced by many other factors, including age, sex, deep vein reflux, and the involved venous segment [7,8,9]. The patient is required to maintain a supine position during MRA scans, which can influence the accuracy of estimations for venous reflux by removing the ability to evaluate the influence of gravitational forces on lower-limb venous reflux. In this study, we aimed to investigate whether any associations exist between changes in lower-limb venous blood flow and the severity of clinical manifestations of varicose veins in the supine position

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Conclusion