Quantifying saphenous reflux

Saphenous size alone cannot be used as an indicator of significant reflux. More than two thirds of the limbs with isolated saphenous reflux have calf pump abnormalities, which also occurred without reflux in the opposite limb-a novel finding. This means that in addition to quantification of reflux volume, calf pump assessment such as with air plethysmography and AMVP is desirable in clinical classes 3 and higher for proper assessment.