Saphenous pulsation on duplex may be a marker of severe chronic superficial venous insufficiency Christopher R. Lattimer, MBBS, FRCS, MS, FDIT, Mustapha.

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Saphenous pulsation on duplex may be a marker of severe chronic superficial venous insufficiency Christopher R. Lattimer, MBBS, FRCS, MS, FDIT, Mustapha Azzam, MD, DIC, MSc, PGD, Evi Kalodiki, MD, DIC, PhD, FRCS, Gregory C. Makris, MD, George Geroulakos, MD, FRCS, DIC, PhD Journal of Vascular Surgery Volume 56, Issue 5, Pages 1338-1343 (November 2012) DOI: 10.1016/j.jvs.2012.04.048 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Duplex tracing of a typical saphenous pulse (SP) waveform. Each major tick represents 1 second. The background SP (4 pulses) is discrete, monophasic, irregular, and of varying amplitude. Reflux, coinciding with inspiration, is seen at the end of the trace. GSV, Great saphenous vein. Journal of Vascular Surgery 2012 56, 1338-1343DOI: (10.1016/j.jvs.2012.04.048) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 The prevalence of reflux (A) and saphenous pulse (SP) (B) across three levels of clinical severity. There was a significant stepwise increase in the prevalence of SP according to clinical severity with no detectable SP in approximately half of the subjects' legs with intermediate clinical severity (C2-3). Journal of Vascular Surgery 2012 56, 1338-1343DOI: (10.1016/j.jvs.2012.04.048) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Pulsation occurred in 75% of legs with great saphenous vein (GSV) reflux (A), while most legs with a saphenous pulse (SP) (89%) had reflux (B). Journal of Vascular Surgery 2012 56, 1338-1343DOI: (10.1016/j.jvs.2012.04.048) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 U-tube manometer to illustrate the principle of hydraulic conductivity. An arterial impulse (a) is met with a corresponding venous pulse (v) provided that both columns are full (not collapsed) and that there is no resistance at the U-bend. Journal of Vascular Surgery 2012 56, 1338-1343DOI: (10.1016/j.jvs.2012.04.048) Copyright © 2012 Society for Vascular Surgery Terms and Conditions