ANATOMICAL AND PATHOPHYSIOLOGICAL FEATURES OF VARICOSE VEINS: USING DUPLEX ULTRASOUND
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Abstract
Varicose veins are a common manifestation of chronic venous insufficiency, often associated with incompetence at key venous junctions and perforator veins. Duplex ultrasonography is the diagnostic modality of choice for evaluating both the anatomical and functional aspects of venous abnormalities. This study aimed to assess the anatomical patterns and distribution of saphenous and perforator incompetence among patients with varicose veins using duplex ultrasound. Methods: A six-month prospective study was conducted in the Departments of Anatomy and Radiodiagnosis, Government Medical College, Srinagar. Of 400 patients presenting with lower limb venous symptoms, 262 (65.5%) diagnosed with varicose veins were included for detailed assessment. Duplex ultrasonography (Philips Affiniti 50/70) with Valsalva and distal compression maneuvers was used to evaluate junctional and perforator incompetence. Data were analyzed using SPSS v20.0, with p-values <0.05 considered statistically significant. Results: Out of 262 patients with varicose vein, 168 (64.1%) demonstrated junction incompetence. Of these, 106 (63.1%) had saphenofemoral junction (SFJ) incompetence, 14 (8.3%) had saphenopopliteal junction (SPJ) incompetence, and 48 (28.6%) had incompetence at both SFJ and SPJ. Perforator incompetence was noted in 213 patients (81.3%), while 49 (18.7%) had competent perforators. The most commonly affected site was the medial mid-third below the knee (70.9%), followed by the medial lower third below the knee (64.3%). Incompetence in the calf (6.1%) and ankle (4.2%) was less frequent. Conclusion: A high prevalence of junctional and perforator incompetence was observed in varicose vein patients, emphasizing the critical role of duplex ultrasonography in diagnosis and treatment planning.
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Dr. Shaziya Afzal
Senior Resident, Department of Anatomy, GMC, Srinagar
Dr. Sabia Nazir
Associate Professor, Department of Anatomy, GMC, Srinagar
Dr. Ghulam Mohammad Bhat
Professor and Head, Department of Anatomy, GMC, Srinagar
Dr. Gulzar Ahmad Haji
Radiologist, Director and owner of Haji Diagnostic and Imaging Centre shopian, J&K