Enhancing Diagnostic Precision and Optimizing Treatment Outcomes through Posture-Specific Measurements of Saphenous Vein Diameters
Keywords:
Chronic venous insufficiency, great saphenous vein, small saphenous vein, postural variation, diagnostic precision, treatment outcomes, venous ulcer prevention, duplex ultrasoundAbstract
Background: Chronic Venous Insufficiency (CVI) is a common condition, and its complications—including ulceration and significant morbidity—are often preventable with accurate early diagnosis. Duplex ultrasonography is the diagnostic standard, but measurements taken in the supine position underestimate venous diameters due to reduced hydrostatic pressure, limiting diagnostic precision and potentially delaying intervention.
Materials and Methods: This review synthesizes evidence from clinical studies comparing Great Saphenous Vein (GSV) and Small Saphenous Vein (SSV) diameters measured in supine versus standing positions. It examines the correlation between posture-specific measurements, CEAP clinical classification, and pathological reflux, highlighting the value of upright imaging in refining diagnostic thresholds and guiding treatment planning.
Conclusion: Standing-position measurements yield significantly larger venous diameters (19–24% increase) and correlate more strongly with clinical severity than supine measurements. Adopting posture-adjusted cutoffs (e.g., 5.88 mm for GSV, 5.29 mm for SSV) improves detection of patients at high risk for disease progression. Standardizing standing duplex ultrasonography is crucial for accurate diagnosis, timely intervention, and minimizing morbidity from advanced varicose vein complications.
