الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 171 |  |  |
| | | from | 171 | | |
Abstract
Aim of the work
To evaluate the role of pre-operative duplex scanning in patients with primary varicose veins in identification of segments of reflux in the superfacial and deep venous segment, mapping the course of these incompetent segments and marking the sites of refluxing perforators.
And to study the relationship between the various reflux patterns identified and the clinical presentation of the patient, to find if there is any correlation with the severity of the condition.
And to study the possible role of the duplex derived flow parameters in the evaluation of the severity of reflux.
Conclusion
Primary varicose venous disease is one important from of CVI. It is important in being heterogeneous and shows too many variations between affected limbs. The disease may also be described as cumulative i.e. the more sites of reflux, the more severe is the clinical presentation of the patient. It is also important because many treatment plans are available for its management, thus it is the dilemma that faces the vascular surgeon to choose the best treatment plan there is to prevent the recurrence ghost. Up till now the pattern of reflux is the most important characterization of CVI in the patients. Superficial venous insufficiency whether isolated or combined with perforator incompetence is the most common pattern among the non complicated CVI classes. whereas deep venous insufficiency complicating SVI and perforator incompetence is most commonly encountered in the complicated CVI classes (2 and 3) and in increasing degrees (number of incompetent deep venous segments per limb) and this adds to the severity of the clinical condition of the patient and aggravates the venous haemodynamics of the limb.
Since the patients differ in their patterns of reflux, treatment has to be tailored for every patient and even for every limb. This necessitates that detailed pre-operative duplex examination has to be carried out for every patient if an adequate surgery is to be carried out. This detailed duplex examination should include the exact segments involved and for superficial and perforator insufficiency, the sites of incompetent perforators and incompetent segments has to be marked on the skin of the patient.
As for duplex-derived measurements of blood flow, these still need further investigations and on a large population of volunteers as well as patients to determine their normal and abnormal figures. Also other studies have to be carried out to correlate the duplex findings (qualitative and quantitative) with the operative outcome in the near and far post operative periods, for their possible future use in planning the surgical procedures for the patient.