COLOUR-DUPLEX ULTRASONOGRAPHIC INVESTIGATION OF SECONDARY VARICOSE VEINS AFTER ILIACOFEMOROPOLITEAL THROMBOSIS

Purpose: The aim of the study was the investigation into the incidence and distribution of secondary varicose veins after deep vein thrombosis as well as their possible correlation with different part of affected deep and superficial lower leg veins.

Methods and Materials: Colour-Duplex scan of deep and superficial leg veins using convex array transducer 3–6MHz and linear array transducer 6–8MHz (Toshiba Corevision SSA 350A) was performed in 61 patients (42 male and 19 female with the mean age of 54 years) with 65 iliacofemoropopliteal thrombosis (4 patients with both leg deep vein thrombosis) in the acute phase of thrombosis, 6 and 12 months later. The cases with earlier leg varicose veins were not included in the study. Junction and trunk of long and short saphenous veins, varicose suprapubic, femoral and below-knee branches, perforating veins and recanalisaton of thrombus in deep veins were observed. All patients were treated with anticoagulants and compression devices. Descriptive and analytic statistical methods were used.

Results: Secondary varicose veins were found in 37 cases (57%) 6 months after the onset of thrombosis and in 43 cases (66%) 12 months after. The last examination showed femoral varicose veins in 11 cases (17%), below-knee in 17 cases (26%) (among them 6 with insufficient perforanting veins) and femoral with below-knee veins in 9 cases (14%)(among them 7 with insufficient perforating veins. 31 cases of secondary varicose veins belonged to long, 3 to short and 3 to both saphenous veins. In 8 patients suprapubic varicose veins were found.

Conclusions: No correlation was found between recanalisation of deep vein thrombosis and secondary varicose veins. All suprapubic varicosity were found in cases with extension of thrombosis to the long saphenous vein junction. All 6 varicose short saphenous veins were found in cases with extension of thrombosis to the short saphenous vein junction. Carefull follow-up of superficial lower leg veins after deep vein thrombosis should be performed during recanalisaton, perhaps indicating a more precise degree of preventive compression therapy.