Comparative Analysis of Great Saphenous Vein and Small Saphenous Vein Diameters: Effects of Position and CEAP Scoring: Protocol

Abstract

Background: Chronic venous insufficiency (CVI) is a prevalent vascular disorder characterized by venous hypertension, varicose veins, edema, and ulceration. Duplex ultrasonography is the primary diagnostic modality; however, supine imaging underestimates vein diameters due to minimal hydrostatic pressure. Posture-specific assessment of great saphenous vein (GSV) and small saphenous vein (SSV) diameters may better reflect clinical severity as graded by CEAP (Clinical, Etiological, Anatomical, Pathophysiological) classification.

Objective: To compare GSV and SSV diameters in standing versus supine positions and assess correlations with CEAP clinical scores in patients with CVI.

Methods: A prospective cross-sectional study will include approximately 370 adult patients presenting with symptomatic venous disease. Duplex ultrasonography (7–10 MHz linear probe) will record segmental diameters of GSV and SSV in both postures. Measurements will be correlated with CEAP (C) grading. Statistical analysis will include paired t-tests/Wilcoxon tests, Pearson/Spearman correlation, and ROC curve analysis to define posture-specific diagnostic thresholds.

Expected Outcomes: Standing-position measurements are expected to yield larger diameters and stronger correlations with CEAP grades. Results will support the development of posture-adjusted diagnostic standards for early and accurate CVI management.