Average Diameter of the Great Saphenous Vein and Its Role in Predicting Chronic Venous Insufficiency among Bangladeshi Population

Abstract

Background: Chronic venous insufficiency (CVI) of the lower extremities is a common but often overlooked condition with varied clinical presentations. The great saphenous vein (GSV) plays a key role in CVI, and its diameter has been suggested as an indicator of venous reflux. The objective of the study is to evaluate the average diameter of the GSV and its potential in predicting CVI in the Bangladeshi population. Materials and Methods: A total of 289 patients with varicose vein symptoms were included from the Vascular Surgery Outpatient Department of Ibrahim Cardiac Hospital & Research Institute between August 2018 and November 2024. The GSV diameter was measured using duplex ultrasonography at various segments, with particular focus on the saphenofemoral junction (SFJ). Data was analyzed using statistical package for social science (SPSS) version 25. Results:  The highest proportion of subjects in the older age groups >60 years (25.3%) and 51-60 years (23.9%) and the male population (62.3%) was more predominant than the female population (37.7%). The mean diameter of the GSV in the reflux group was significantly larger (6.31 ± 1.71 mm) compared to the normal group (5.80 ± 1.57 mm, P = 0.036). ROC curve analysis revealed that a GSV diameter cutoff of >5.05 mm had moderate sensitivity (78.0%) and specificity (67.0%) in predicting reflux, with an area under the ROC curve of 0.596 (95% CI: 0.514 – 0.678, P = 0.024). Conclusion: In conclusion, this study demonstrates that the diameter of the GSV, particularly at certain segments, can be a useful indicator of chronic venous insufficiency. The cutoff value of 5.05 mm for predicting reflux, while statistically significant, shows moderate sensitivity and specificity.