Tesis

Hubungan Refluks Vena Perforator dan Vena Safena Magna dengan Pigmentasi Tungkai pada Pasien Dengan Penyakit Vena Kronik (CEAP C3 dan C4) = Relationship Between Perforator Vein and Great Saphenous Vein Reflux With Lower Limb Pigmentation in Patients with Chronic Venous Disease (CEAP C3 and C4).

Latar Belakang: Pigmentasi tungkai merupakan manifestasi penting penyakit vena kronik (CVD) akibat hipertensi vena jangka panjang. Refluks vena perforator dan vena safena magna diduga memiliki peran utama dalam terjadinya perubahan kulit tersebut. Metode: Penelitian potong lintang prospektif ini melibatkan 40 pasien CVD CEAP C3–C4 yang menjalani pemeriksaan USG Doppler di RSCM dan RS Hermina Depok periode Agustus– Oktober 2025. Refluks vena perforator dan vena safena magna dinilai dengan USG Doppler, sedangkan pigmentasi dinilai menggunakan Venous Clinical Severity Score (VCSS). Analisis dilakukan secara bivariat dan multivariat. Hasil: Refluks vena perforator Cockett ditemukan pada 17 pasien (42,5%) dan Boyd pada 6 pasien (15,0%). Refluks vena safena magna ditemukan pada hampir seluruh pasien, dengan distribusi: SFJ 100%, mid-thigh 95,0%, lower thigh 82,5%, upper knee 70,0%, dan lower knee 57,5%. Refluks perforator Cockett dan Boyd berhubungan signifikan dengan kejadian pigmentasi (p < 0,05). Pada analisis multivariat, refluks vena safena magna segmen upper knee berhubungan bermakna dengan pigmentasi (p = 0,020; aOR 10,24; IK95% 1,445–72,57), demikian pula faktor prolonged standing (p = 0,032; aOR 6,54; IK95% 1,17–36,52). Kesimpulan: Refluks vena perforator dan refluks vena safena magna berhubungan signifikan dengan kejadian pigmentasi tungkai pada pasien penyakit vena kronik CEAP C3 danC4.
Kata kunci: penyakit vena kronik, refluks vena perforator, refluks vena safena magna, pigmentasi tungkai, CEAP.


Background: Lower limb pigmentation represents an important manifestation of chronic venous disease (CVD) due to long-standing venous hypertension. Perforator vein and great saphenous vein (GSV) reflux are suspected to play major roles in the development of these skin changes. Methods: This prospective cross-sectional study included 40 patients with CVD classified as CEAP C3–C4 who underwent duplex ultrasound at RSCM and Hermina Depok Hospital from August to October 2025. Perforator vein and GSV reflux were evaluated using Doppler ultrasound, while pigmentation was assessed using the Venous Clinical Severity Score (VCSS). Bivariate and multivariate analyses were performed. Results: Cockett perforator reflux was identified in 17 patients (42.5%) and Boyd perforator reflux in 6 patients (15.0%). GSV reflux was detected in nearly all patients, with segmental distribution as follows: SFJ 100%, mid-thigh 95.0%, lower thigh 82.5%, upper knee 70.0%, and lower knee 57.5%. Both Cockett and Boyd perforator reflux showed significant associations with pigmentation (p < 0.05). Multivariate analysis demonstrated that GSV upperknee reflux was independently associated with pigmentation (p = 0.020; aOR 10.24; 95% CI 1.445–72.57), as well as prolonged standing (p = 0.032; aOR 6.54; 95% CI 1.17–36.52). Conclusion: Perforator reflux and great saphenous vein reflux are significantly associated with lower limb pigmentation in patients with CVD CEAP C3 and C4.
Keywords: chronic venous disease, perforator vein reflux, great saphenous vein reflux, skin pigmentation, CEAP