The importance of great saphenous vein types and segmental aplasia in venous reflux.

Abstract

To investigate the relationship among great saphenous vein (GSV) anatomic type, segmental aplasia, and reflux. Color Doppler ultrasonography (CDUS) was performed on 475 legs of 277 consecutive patients with venous symptoms between November 2015 and August 2016. Exclusion criteria were previous venous surgery and venous thrombosis. Five GSV types were identified based on the saphenous compartment at thigh level, and segment aplasia and reflux were investigated. The most frequent GSV type was type A, ie, a single GSV extending within the saphenous compartment with no accompanying large parallel tributary (53%), and the least frequent type was type B, GSV duplication (1.3%). Patients with and without reflux showed similar distributions of GSV type (p = 0.389). Segmental aplasia was observed in 117 (24.63%) of 475 legs. The mean age of patients with GSV reflux was compared between patients with and without aplasia (p = 0.798). The frequency of venous reflux was nearly identical across GSV types. The frequency of segmental aplasia was similar in patients with and without reflux. Despite these similarities, defining GSV type and identifying segmental aplasia can provide guidance for treatment. In particular, type D GSVs, defined by the presence of an anterior accessory branch, should be investigated when performing CDUS. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:332-336, 2017.