Patterns of Saphenous Vein Reflux and Treatment Plan

Abstract

Varicose vein is a prevalent disease and a cause of substantial morbidity. Venous reflux often originates from saphenous trunks and their tributaries. The great saphenous vein and small saphenous vein have major anatomical variations due to their embryological origin. Understanding of anatomic variation and reflux pattern is important to decide the target lesions for treatment and treatment modalities for symptom relief effectively and to prevent the future complications and recurrence. In this review, we purposed to review the reflux pattern of the saphenous origin and the corresponding treatment methods.

Analysis of Clinical Experience of Patients with Lower Extremity Edema

“…They also noted that there are limited data on the treatment effect of edema when only below-knee great saphenous vein (GSV) reflux or segmental reflux is present (7). Treatment for segmental reflux is generally unnecessary, even in the absence of edema (8). There seems to be a difference in perspectives regarding clinical class C3.…”

The Teupitz Shunt Classification for CHIVA Strategy

“…To implement the CHIVA strategy, hierarchy of venous flow in the leg must be assessed using Doppler ultrasonography. Various patterns of saphenous reflux have been previously described; (5,6) these patterns are useful for guiding saphenous ablation therapy. In the CHIVA strategy, Teupitz shunt classification is used to categorize flow patterns in saphenous veins (7).…”

Prevalence and Clinical Implication of Nonsaphenous Vein Reflux with or without Pelvic Venous Disease

“…The prevalence of non-saphenous vein reflux is not well-established, but emerging evidence suggests that it may be more common than previously thought. Studies have shown that non-saphenous vein reflux may be present in up to 9∼35% of patients with chronic venous insufficiency, indicating that it is a significant and under-recognized problem (2)(3)(4)(5).…”