Prevalence of venous reflux in the general population on duplex scanning: The Edinburgh Vein Study

Purpose: The prevalence of reflux in the deep and superficial venous systems in the Edinburgh population and the relationship between patterns of reflux and the presence of venous disease on clinical examination were studied. Methods: A cross-sectional survey was done on men and women ranging in age from 18 to 64 years, randomly selected from 12 general practices. The presence of varicose Veins and chronic venous insufficiency was noted on clinical examination, as was the duration of venous reflux by means of duplex scanning in 8 vein segments on each leg. Results were compared using cut-off points for reflux duration (RD) of 0.5 seconds or more (RD greater than or equal to 0.5) and more than 1.0 second (RD > 1.0) to define reflux. Results: There were 1566 study participants, 867 women and 699 men. The prevalence of reflux was similar in the right and left legs. The proportion of participants with reflux was highest in the lower thigh long saphenous vein (LSV) segment (18.6% in the right leg and 17.5% in the left leg for RD greater than or equal to 0.5), followed by the above knee popliteal seg ments (12.3% in the right leg and 11.0% in the left leg for RD greater than or equal to 0.5), the below knee popliteal (11.3% in the right leg and 9.5% in the left leg for RD greater than or equal to 0.5), upper LSV (10.0% in the right leg and 10.8% in the left leg for RD greater than or equal to 0.5) segments, the common femoral vein segments (7.8% in the right leg and 8.0% in the left leg for RD greater than or equal to 0.5), the lower superficial femoral vein (SFV) segments (6.6% in the right leg and 6.4% in the left leg for RD greater than or equal to 0.5), and the upper SFV (5.2% in the right leg and 4.7% in the left leg for RD greater than or equal to 0.5) and short saphenous vein (SSV) (4.6% in the right leg and 5.6% in the left leg for an RD greater than or equal to 0.5) segments. Ln the superficial vein segments, there was little difference in the occurrence of reflux whether RD greater than or equal to 0.5 or RD > 1.0 was used; but in the different deep vein segments, the prevalence of reflux was 2 to 4 times seater for RD greater than or equal to 0.5 rather than RD > 1.0. Men had a higher prevalence of reflux in the deep vein segments than women, reaching statistical significance (P less than or equal to .01) in 4 of 5 segments for RD 2 0.5. In general, the prevalence of reflux increased with age. Those with "venous disease" had a significantly higher prevalence of reflux: in all vein segments than those with "no disease" (P less than or equal to .001). Conclusion: The prevalence of venous reflux in the general population was related to the presence of "venous disease," although it was also present in those without clinically apparent disease. There was a higher prevalence of reflux in the deep veins in men than the deep veins in women. Follow-up study of the population will determine the extent to which reflux is a predictor of future disease and complications.