Volume 50, Issue 1 Spring 2026 JVU 501-16 | Ultrasonographic Venous Abnormalities in CEAP C1 Patients-Ultrasonographic Venous Abnormalities in CEAP C1 Patients

Ultrasonographic Venous Abnormalities in CEAP C1 Patients

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This prospective study by Chaivanit et al., published in the Journal for Vascular Ultrasound (2026), investigated the prevalence and characteristics of venous abnormalities detected by Doppler ultrasound (DUS) in Thai patients classified as CEAP C1—those exhibiting mild chronic venous disease (CVD) such as telangiectasias and reticular veins without overt venous insufficiency symptoms. The study enrolled 94 patients (177 limbs; 93.6% female; mean age 44.9 years) undergoing lower limb DUS between December 2022 and May 2023.<br /><br />Key findings include the detection of venous reflux, a marker of venous insufficiency, in 14.1% of limbs, exclusively manifesting as reflux (no thromboses). Reflux was predominantly found in superficial veins, particularly great saphenous veins (GSV, 6.2%), and perforator veins (4.5%), with very rare involvement of deep veins (1.1%) and no abnormalities detected in short saphenous veins. A significant association was seen between perforator vein diameter ≥1.8 mm and reflux presence (P=0.017), while GSV diameter and patient factors (age, sex, body mass index, underlying diseases, or prolonged standing) were not significantly linked to reflux. The study suggests that in CEAP C1 patients, routine examination of short saphenous veins and augmentation testing of perforators smaller than 1.8 mm may be unnecessary, potentially streamlining ultrasound protocols and conserving time.<br /><br />The study highlights ethnic differences in reflux prevalence and suggests that although C1 is an early clinical stage, subtle hemodynamic changes are detectable via DUS. The findings advocate for tailored ultrasound screening strategies focusing on superficial and select perforator veins in mild CVD. Limitations include single-center design, a predominance of female and Thai ethnicity limiting generalizability, and a focus on structural and Doppler findings without correlating symptoms or intra/inter-observer variability assessments.<br /><br />Overall, the research provides valuable insights into the ultrasound detection of venous abnormalities in mild chronic venous disease, supporting optimized, less labor-intensive imaging protocols that focus on clinically relevant venous segments in this population.

Keywords

Venous abnormalities

Doppler ultrasound

Chronic venous disease

CEAP C1

Venous reflux

Great saphenous vein

Perforator veins

Short saphenous vein

Ultrasound screening

Thai patients