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Perforator and Axial Venous Insufficiency in Sickle Cell Disease Patients with and without Leg Ulceration

Chronic or recurrent leg ulceration occurs in at least 25% of patients with sickle cell disease (SSD). Conflicting data exist concerning the association between SSD leg ulcers and axial venous insufficiency. To determine whether the incidence of perforator vein insufficiency (PVI) is greater in the ulcerated legs of SSD patients than in those without ulcers, the legs of 46 SSD patients, 25 of whom had chronic ulceration and of 19 normal young adult volunteers, were investigated with color-flow venous duplex Doppler sonography. PVI was found in 25 of 37 ulcerated legs and in 14 of 55 nonulcerated legs of SSD patients. The difference was significant (odds ratio 6.2). PVI may contribute to leg ulceration in SSD disease.