Hemodynamics of the sapheno-femoral junction: Mathematical modeling and clinical implications in chronic venous disease

Background: The incompetence of the sapheno-femoral junction (SFJ) represents a major point in the actual discussion on the venous hemodynamics of lower limbs in chronic venous disease (CVD). Methods: From 2014 June to 2017 June in the laboratory of non-invasive vascular diagnostics of the Operative Vascular Surgery Unit of the University Hospital of Ferrara we recruited 122 patients (sex: 37 males, 85 females; age range: 22-72 years; median age: 51 years). All patients were subjected to morphologic and geometric evaluations; vessels diameters, speed and direction of hematic flow were evaluated by Doppler echocardiography (DECG) technique. We performed a mathematical modeling among different hemodynamic evaluations through the use of DECG in order to evaluate local fluid dynamical parameters. Results: The analysis of numerical results allowed the identification of three different hemodynamic situations that are particularly critical for the SFJ circulation. Conclusions: The present experience represents an evidence based medicine study that in the next future could be useful for clinical decision-making process in CVD in order to simplify the choice of the therapeutic options, specific for each patient and based on objective, controllable and reproducible parameters.