Background: Greater Saphenous Vein (GSV) courses within saphenous compartment,
an adipose-filled space bound by fasciae provides structural support. Ultrasound Shear-Wave Elastography
(SWE) provides objective and quantitative data on tissue shear elasticity modulus.
Objective: This study aims to analyze possible associations between early stage GSV insufficiency
and saphenous intracompartmental SWE measurements.
Methods: Two-hundred consecutive patients, ages 22 to 81 (mean=44.3) years, with venous insufficiency
symptoms underwent Doppler and SWE examinations. Patients had no visible or palpable
sign of venous disease or had telangiectasia and reticular veins only. Analyses regarding patient
age, gender, presence of venous insufficiency of GSV proper and intracompartmental connective
tissue elasticity were performed.
Results: Ninety-six patients had Doppler evidence for either bilateral or unilateral insufficiency of
GSV proper at mid-thigh level. Intracompartmental elasticity of patients with venous insufficiency
(mean=4.36±2.24 kilopascals; range 1.55 to 10.44 kPa) did not differ significantly from those with
normal veins (mean=4.82±2.61 kPa; range 2.20 to 12.65 kPa) (p=0.231). No threshold for predicting
the presence of venous insufficiency could be determined. Neither were there any correlations
between age, gender and intracompartmental elasticity. In patients with unilateral insufficiency,
however, elastography values around insufficient veins were significantly lower compared to contralateral
normal GSV (p<0.001).
Conclusion: Many intrinsic and patient factors affect intracompartmental connective tissue elastography
measurements; thus, cut-off values obtained from specific populations have limited generalizability.
Nevertheless, statistically significant intrapatient differences of intracompartmental elasticity
among diseased and normal saphenous veins indicate that lack of elastic support from surrounding
connective tissues contributes to venous insufficiency in early stages.