I had an ultrasound that showed r>l spiders around ankle, 2 sec reflux rt deep popliteal, everything else OK. He said my veins are great. But, I read >.5 is a problem. Can you have isolated 2 sec reflux and not be pathologic? Should I wear compression hose?
The popliteal vein is classified as a deep vein. While deep vein reflux is defined as greater than 1-2 seconds, superficial vein reflux is defined as greater than 0.5 seconds. Your popliteal vein is within normal parameters. However, your superficial saphenous veins should be tested as well as they often cause ankle spider veins.
Published on Jul 11, 2012
If you are referring to the popliteal vein, which is a deep vein, and no superficial vein reflux, then basically there is no treatment available of a practical nature other than compression stockings indicated. This may have some protective effect but is not well supported in the literature due to the difficulty of designing and proving convincing studies on this.
Published on Jul 11, 2012
The reflux in the popliteal (deep) vein is indeed abnormal and likely contributes to your symptoms. You are correct about the > 0.5 sec of reflux, but only for the superficial venous system. However, there are no treatments available for deep venous reflux, only treatments for superficial venous reflux. Treating the deep veins in the same fashion as the superficial veins will cause more problems (like pain and swelling) than you currently have. Ablation of deep veins, such as the popliteal vein, is strictly off limits. So, if the ultrasound only showed the popliteal vein reflux and nothing else, then you do have a pathologic condition, but one that cannot be treated. So, in a sense, everything is OK.
Published on Jul 11, 2012
Deep vein (popliteal or saphenous) reflux can be present with no symptoms and no reflux in the saphenous veins). Many people have spider veins in the ankles without any type of deeper reflux. This is usually inherited. I would, however, recommend a compression stocking or sock of at least 15-20 mmHg when travelling (flying , driving), sitting for long periods of time and during illness. These can be stylish like regular socks and hose and very comfortable. They should be measured and fitted correctly. A healthy lifestyle, weigh management, drinking plenty of fluids, not smoking and exercise all improve circulation.
Published on Jul 11, 2012
The normal amount of reflux time in veins varies by their size. A popliteal vein normally will have a second or so of reflux and depending on its size, 2 seconds could be normal in that vein. It could also represent some deep venous insufficiency, which would warrant compression stockings. I would recommend you pursue further clarification with your doctor.
Published on Jul 11, 2012
There is a difference between superficial vein reflux and deep venous reflux. Superficial reflux could affect spider and varicose veins. Deep reflux has no relationship to these veins. Many people have findings on ultrasound of deep reflux but are asymptomatic so this is not an uncommon finding and I agree with your physician. Wearing support hose would be advised.
Published on Jul 11, 2012
Yes, you could have isolated popliteal vein reflux. While this is not normal, it is not a sign of severe vein disease. The patient could have a normal life. Compression stockings are a good idea.
Published on Jul 11, 2012