ArticleJournal of ultrasound2026
Predictive value of great and small saphenous vein diameters for venous reflux in lower extremity chronic venous insufficiency: A segmental analysis using duplex ultrasonography.
Article in Journal of ultrasound, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic venous disease is prevalent, particularly in the form of varicose veins, and often involves saphenous vein incompetence. While correlations between vein diameters and reflux presence are established, associations with reflux duration remain underexplored. This study aimed to evaluate the relationship between great and small saphenous vein diameters and reflux durations across lower limb segments in varicose vein patients, and to determine predictive diameter thresholds for reflux.
methodsIn a cross-sectional study with case-control component (2021-2023, Blinded), 753 incompetent veins were analyzed for diameter-reflux correlations using Pearson/Spearman coefficients. Reflux was defined as > 1000 ms at saphenofemoral junction (SFJ) or > 500 ms elsewhere. A subsample of 300 cases was compared to 303 healthy controls for diameter differences via t-tests and receiver operating characteristic (ROC) analyses to identify optimal cut-offs via Youden index.
resultsSignificant negative correlations were found proximally (SFJ: r = - 0.163, P < 0.05; cranial great saphenous vein [GSV]: r = - 0.150, P < 0.01) and positive correlation distally (mid-calf GSV: r = 0.130, P < 0.01; caudal small saphenous vein [SSV]: r = 0.300, P < 0.01). Cases had larger diameters across segments (all P < 0.001). Highest ROC accuracy was for cranial GSV (5 mm cut-off; area under curve [AUC] = 0.775; accuracy = 72.65%) and cranial SSV (3.6 mm; AUC = 0.779; accuracy = 70.02%); lowest for ankle GSV (2.3 mm; accuracy = 53.31%) and caudal SSV (2.2 mm; accuracy = 59.83%).
conclusionsSegment-specific diameter-reflux associations highlight the inadequacy of diameter alone for assessing reflux duration, necessitating comprehensive duplex ultrasound evaluation for venous insufficiency management.
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