Prevalence of gastrocnemius vein insufficiency using color-coded Doppler ultrasound (modifications of the therapeutic strategy)

The importance of morphologic and dynamic lesions of the gastrocnemius vein is underestimated. Color-coded Duplex scanning was performed in 483 patients with varicosities and 869 legs with some venous abnormalities were discovered. Two types of lesion on gastrocnemius veins were founded: incompetence and dilatation usually located on the medial gastrocnemius vein. In 29.34% of the limbs, a medial gastrocnemius vein incompetence was present and a dilatation in 15.42%. Medial gastrocnemius vein incompetence was associated with a mid calf gastrocnemius communicating vein incompetence in 25%. Physiopathological hypothesis could be drawn of our observations. Gastrocnemius veins when incompetent should be ligated flush to the popliteal vein. The high prevalence of gastrocnemius vein should be considered in the management of varicose veins and color-coded Duplex scanning routinely performed before surgery.