Clinical and ultrasound parameters of subcutaneous veins of conditionally healthy legs in patients with varicose veins

The article presents the results of clinical and ultrasound examination of the subcutaneous veins of the lower extremities of 165 patients, including 20 healthy volunteers, 100 patients with chronic venous insufficiency (CVI) in stages C3–C4a and 45 patients with trophic ulcers (stage C6) according to the CEAP classification of 2020. The focus was on measuring the internal lumens of the large (LSV) and small subcutaneous veins (SSV) on the affected and conditionally healthy lower extremities. Conditionally healthy lower limb is a limb without clinical and ultrasound signs of CVI in the presence of these signs on the diseased opposite limb. Mean diameters of LSV and SSV in patients with CVI (classes C3–C4a and C6 according to the CEAP 2020 classification) significantly exceeded those of healthy volunteers (p < 0.01): LSV at C6 – 8.1 ± 1.5 mm, at C3–C4a – 6.8 ± 1.6 mm, in healthy volunteers – 3.3 ± 0.4 mm. On conditionally healthy limbs of patients with signs of CVI on the second lower limb, the internal dimensions of the SSV were significantly larger than in healthy volunteers, which indicates a systemic nature of the disease even in the absence of clinical manifestations. The frequency of conditionally healthy limbs decreased from 84% at stages C3–C4a to 42% at stage C6 according to the CEAP classification of 2020, which indicates the progression of the pathology. The results of the study show the commonality of pathophysiological processes in the venous walls of both lower extremities in CVI. That is why dynamic ultrasound control of subcutaneous veins of conditionally healthy limbs is advisable in patients with signs of CVI on a sick lower limb both before and after surgery.

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