Hach W 1977
Hach W 1977
The term "truncal venous insufficiency" is a term introduced by the phlebologist W. Hach in 1977 and is based on the pathophysiological concept of reflux-induced recirculation and the resulting venous hypertension. In principle, this concept of varicosis is still valid today. Here, the upper and lower insufficiency point of a truncal vein plays a decisive role.
Upper point of insufficiency: The upper point of insufficiency is the most proximal point of the truncal vein at which an insufficient transfascial communication (perforating vein) can be detected.
Complete truncal venous insufficiency: If the proximal point of insufficiency is located in the magna or para-saphenous orifice, this pathological condition is called "complete truncal venous insufficiency".
Incomplete truncal venous insufficiency: In incomplete truncal venous insufficiency the proximal point of insufficiency is not in the magna or parva saphenous orifice but distal to it.
Lower insufficiency point: The lower insufficiency point is the distal point of the truncal vein with a still sufficient venous valve. Here a lateral branch varice opens into the truncal vein and drains the hypertonic reflux area (see also recirculation according to Hach).
Score for graduation of truncal venous insufficiency: A score for graduation of the severity of truncal varicosis introduced by W. Hach et al. in 1997 is still a proven practice today:
Magna saphenous vein
saphenous vein