15.Adaptative Response of Lower Extremity Veins to the Iliac Valve Regurgitation Disease

摘要

Summary Background: Varicose veins of the lower extremities is one of the most common circulatory diseases but there is little information on the comparative incidence of the regurgitation of femoral and iliac valves. The objective of this study was to analyze the occurrence of selective valve regurgitation in the external iliac vein with or without an association with insufficiency of the valves in the femoral or great saphenous veins. Methods: The venous system of the lower limbs of thirty patients aged between 21 and 75 years old (mean 39 years old) with varicose veins in the lower extremities were studied with Color Flow Duplex Scanning aiming to investigate the regurgitation in the iliac, femoral, popliteal and great saphenous veins. Results: Iliac regurgitation greater than or equal to 26.0 cm/s present in 19 limbs was isolated (without reflux in the great saphenous ostium valve) in only one (5.3%) case. In cases where iliac regurgitation was less than 26.0 cm/s, regurgitation in the great saphenous vein ostium was absent in four (14.3%) limbs. Considering the total of 60 lower extremities studied, the incidence of iliac regurgitation was seen in 47 (78.3%) cases, and dysfunction of the saphenous ostium valve in 45 (75%) cases. Otherwise, saphenous ostium valve reflux without iliac regurgitation occurred only in three (6.3%) cases, with only one case above 25.9 cm/s. Conclusion: Anomalies of valvular function in iliac veins present significant correlation with the intensity of insufficiency in the great saphenous vein ostium valve and with the gravity of the varicose veins in the lower extremities.