Saphenous vein wall thickness in age and venous reflux-associated remodeling in adults

Abstract

Objective: This prospective study was designed to determine the great saphenous vein (GSV) wall thickness in age-related and venous reflux-associated remodeling.

Methods: GSV wall thickness was measured in the thigh and calf using a duplex ultrasound 17-MHz transducer. Interobserver and intraobserver variability studies were performed. Two healthy control groups, each with 10 individuals (20 limbs), were selected on the basis of age. Group 1 had a mean age of 21 years, and group 2 had a mean age of 64 years. Forty patients with chronic venous disease signs and symptoms and GSV reflux of >2 seconds were enrolled. The vein wall thickness was assessed in vein segments with reflux and adjacent segments without reflux in the patient group.

Results: The measurements were valid as the variability for each rater was far below the difference in vein wall thickness measurements in all comparisons. In controls and patients, respectively, rater one had a range of 0.11 mm and 0.16 mm, and rater two had a range of 0.09 mm and 0.15 mm. The vein wall thickness significantly increased (P < .05) between each group in the following order: control group 1 (0.30 ± 0.03 mm), control group 2 (0.40 ± 0.05 mm), patients' vein segments without reflux (0.45 ± 0.07 mm), and patients' vein segments with reflux (0.58 ± 0.1 mm). These measurements were from the thigh and were comparable to those in the calf. The thickened, nonrefluxing segments were seen both proximal and distal to segments with reflux.

Conclusions: This human in vivo study demonstrated that GSV wall thickness significantly increases with age and in patients with venous reflux. The increased vein wall thickness in nonrefluxing segments of chronic venous disease patients suggests that the venous wall can be affected before reflux is present in a particular segment.