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BACKGROUND: Varicose veins of the lower extremities is one of the most common circulatory diseases but no published reports describing the associated comparative rates of femoral and iliac valve regurgitation were found. OBJECTIVE: To study the occurrence of selective valve regurgitation in the external iliac vein, associated or not with insufficiency of the valves in the femoral or great saphenous veins. METHOD: With the approval of the Ethics Committee of the São Francisco de Assis Cardiovascular Foundation, the venous system of the lower limbs of twenty-four female (80%) and six male (20%) patients aged between 21 and 71 years old (mean 39 years old), with varicose veins in the lower extremities, were studied with Color Flow Duplex Scanning (Esaote array; 7.5 MHz transducer; 2-dimensional, pulsed Doppler and color flow techniques). The aim was to investigate the regurgitation in the iliac, femoral, popliteal and great saphenous veins. The results were statistically analyzed using variance analysis and student T-test with a significance level of 0.05. RESULTS: Iliac regurgitation ³ 26.0 cm/s, which was present in 19 limbs, occurred isolated without reflux in the great saphenous ostium valve only in one case (5.3%). In the cases with iliac regurgitation < 26.0 cm/s, the absence of regurgitation in the great saphenous vein ostium occurred in four limbs (14.3%). Considering the total of 60 lower limbs studied, iliac regurgitation was observed in 47 (78.3%) cases and dysfunction of the saphenous ostium valve in 45 (75%) cases. Furthermore, saphenous ostium valve reflux without iliac regurgitation occurred only in three cases (6.3%), which in only one case was above 25.9 cm/s. CONCLUSION: In conclusion anomalies of the valvular function in the iliac veins present a significant correlation with the intensity of the insufficiency in the great saphenous vein ostium valve and the gravity of varicose veins in the lower limbs. FUNDAMENTOS: As varizes de membros inferiores constituem uma das mais comuns doenças circulatórias, contudo, até onde foi possível alcançar, não foram encontradas na literatura médica publicações científicas descrevendo a incidência comparativa de regurgitação valvar em veias ilíacas e safenas magnas. OBJETIVO: Estudar a ocorrência de regurgitação valvar em veias ilíacas, associada ou não com insuficiência de válvulas em veias femoral ou safena magna. MÉTODO: Em 30 pacientes portadores de varizes em membros inferiores, com idade entre 21 e 71 anos (média de 39 anos), sendo seis (20 %) do sexo masculino, foram estudados exames Duplex Scanning (Aparelho Esaote; transdutor de 7,5 MHZ, com técnica bidimensional, doppler pulsado e fluxo a cores), analisando a regurgitação em veias ilíaca, femorais , safenas magnas e poplíteas. RESULTADOS: A regurgitação ilíaca importante, igual ou superior a 26,0 cm/s presente em 19 membros, ocorreu isoladamente, sem refluxo na válvula ostial da veia safena em apenas um (5,3%) caso. Nos casos com regurgitação ilíaca menor (Classes 1 a 3), a ausência de regurgitação ostial da veia safena ocorreu em quatro (14,3%) membros. No total de 60 membros estudados, houve incidência de regurgitação ilíaca em 47 (78,3%) casos, e de disfunção valvar ostial da safena magna em 45 (75%) casos. Contrariamente, a regurgitação ostial safena sem refluxo ilíaco ocorreu somente em três (6,3%) casos, sendo em apenas um caso (2,1%) superior a 25,9 cm/s. CONCLUSÃO: Concluiu-se que as anomalias da função das válvulas em veias ilíacas representam o fator determinante de maior correlação com a intensidade da insuficiência valvular ostial da veia safena magna e com a gravidade das varizes em membros inferiores

Iliac valve regurgitation disease: implications for the surgical approach of the venous insufficiency in the lower extremities