Study indicates reflux time “best utilised as a cut-off” for diagnosis of venous insufficiency


GSV ablationIn a prospective study of patients undergoing great saphenous vein (GSV) ablation, researchers found no correlation between maximum reflux time and symptom severity as measured by Venous clinical severity score (VCSS).

Authors Damianos G Kokkinidis (Yale University, New Haven, USA) and colleagues write in the February edition of Phlebology that it is unclear whether reflux time independently correlates with severity of symptoms in patients with GSV reflux. It was their aim, therefore, to compare venous reflux time and VCSS in this patient group.

The investigators prospectively enrolled 80 patients (mean age 64 years, 56% female) presenting for treatment of symptomatic venous reflux to one teaching hospital between August 2020 and January 2022. They note that VCSS was conducted by the operating physicians as part of the initial screening visit or immediately before the ablation.

Of the total number of patients included in the study, the authors specify that 57 underwent ablation with radiofrequency, while 23 were treated with cyanoacrylate adhesive.

Kokkinidis et al report in Phlebology that VCSS values ranged from two to 20, with a median value of seven, and that the mean reflux time was 5.3 seconds. Additionally, they relay that the Spearman rank correlation yielded a value of rs=-0.123, which they say was not significant. The patients with concomitant deep vein reflux had higher VCSS, Kokkinidis and colleagues add, noting finally that analysis of patients with only superficial vein reflux (n=45) also demonstrated a poor correlation between VCSS and reflux time.

Based on their conclusion that this prospective study did not demonstrate a correlation between reflux time and VCSS, the authors suggest that reflux time is “best utilised as a cut-off” for the diagnosis of the presence of venous insufficiency.

In the discussion of their findings, Kokkinidis et al recognise that their study has some limitations, including its small sample size, which they write “may have led to an inability to detect correlation between reflux time and VCSS”. They also note that the number and size of affected tributaries, as well as the duration and presence of symptoms, were not evaluated.


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