Venous Reflux Patterns

  • Sergio Gianesini
  • Paolo Zamboni
  • Erika Mendoza


Classical physiology of leg veins was described based on physics rules and anatomic observations. While physics rules find application only to a certain extent, as veins are not ideal tubes nor blood ideal fluids, the knowledge is important to understand reflux and draining pathways. Ultrasound has revolutionized the knowledge in phlebology, allowing a better subdivision of reflux escape points, refluxing pathways and re-entry points. In the same way, a distinction of the function of dilated perforators into pressure equalizers, escape points and re-entry pathways was possible. The combination of this knowledge allowed the subdivision of pathologic pathways into shunt types. Once understood the haemodynamics, the consequence of which strategy to apply in saphenous vein sparing surgery is an easy second step.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sergio Gianesini
    • 1
    • 2
  • Paolo Zamboni
    • 3
    • 4
  • Erika Mendoza
    • 5
  1. 1.Vascular Diseases CenterUniversity of FerraraFerraraItaly
  2. 2.USUHS UniversityBethesdaUSA
  3. 3.School of Vascular Surgery and Vascular Diseases CenterUniversity of FerraraFerraraItaly
  4. 4.Unit of Translational SurgeryAOU FerraraFerraraItaly
  5. 5.VenenpraxisWunstorfGermany

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