Venous Mapping & Preoperative Assessment Flashcards

What does the venous filling index (VFI) measured by air plethysmography (APG) primarily quantify?

Answer: Rate and degree of venous reflux

The VFI reflects how rapidly the venous volume of the leg refills after exercise, serving as a quantitative measure of the severity of venous reflux.

At the saphenofemoral junction (SFJ), the GSV drains into which vessel?

Answer: Common femoral vein

The GSV joins the common femoral vein at the SFJ, located in the femoral triangle just below the inguinal ligament.

In the CEAP classification, which condition does the subclass C4b describe?

Answer: Lipodermatosclerosis or atrophie blanche

C4b specifically identifies lipodermatosclerosis (fibrotic skin thickening) or atrophie blanche (white scarred skin), which represent more advanced skin changes than C4a.

What is the minimum reflux duration at the saphenofemoral junction that is considered pathologic on duplex ultrasound?

Answer: >0.5 seconds

Reflux duration exceeding 0.5 seconds in the superficial venous system (including the SFJ) is the accepted threshold for pathologic incompetence.

When performing GSV mapping for CABG, which set of parameters must be documented along the vein course?

Answer: Diameter, continuity, compressibility, and marked skin location

Comprehensive GSV mapping documents luminal diameter at multiple levels, vein continuity, wall compressibility confirming patency, and the skin-marked course for intraoperative guidance.

The perforating veins of Cockett are clinically significant in venous ulcer disease and are located in which anatomical region?

Answer: Medial lower leg

Cockett's perforators connect the posterior arch vein to the posterior tibial veins along the medial lower leg, directly beneath the gaiter zone where venous ulcers typically occur.

Which duplex finding best distinguishes secondary varicose veins from primary varicose veins?

Answer: Deep venous obstruction or reflux causing superficial venous dilation

Secondary varicose veins develop as a consequence of identifiable deep venous pathology (obstruction or reflux), whereas primary varicose veins arise without an underlying deep venous cause.