Related Experiment Video
Updated: Sep 28, 2026
Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
Accuracy of hand-held Doppler in planning the operation for primary varicose veins
T Rautio1, J Perälä, F Biancari
1Department of Surgery, Oulu University Hospital, Finland.
Insights
Hand-held Doppler (HHD) is not accurate enough for planning varicose vein surgery. Duplex ultrasonography is recommended as the preferred preoperative diagnostic tool for better surgical planning.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Medical Device Evaluation
Background:
- Primary varicose veins affect a significant portion of the population.
- Accurate preoperative assessment is crucial for successful surgical outcomes.
- Current diagnostic methods require evaluation for efficacy.
Purpose of the Study:
- To determine if hand-held Doppler (HHD) examination is sufficient for screening and surgical planning of primary varicose veins.
- To compare the diagnostic accuracy of HHD with clinical examination and duplex ultrasonography.
Main Methods:
- Prospective study involving 111 patients (142 legs) with primary varicose veins.
- Clinical examination, HHD, and duplex ultrasonography performed on the same day.
- Treatment plans recorded separately after each examination.
Main Results:
- HHD showed low sensitivity (56% at SFJ, 23% at SPJ) and moderate specificity for detecting venous insufficiency.
- Clinical examination led to incorrect treatment plans in 26% of cases.
- HHD-based plans required modification in 9.1% of limbs based on duplex findings, including incorrect vein identification or procedure selection.
Conclusions:
- Hand-held Doppler examination is inadequate for preoperative evaluation of primary varicose veins.
- Duplex ultrasonography is the superior diagnostic method for accurate surgical planning in these patients.
Objective:
To evaluate whether hand-held Doppler (HHD) examination is an adequate screening test in planning surgical treatment for primary varicose vein.
Design:
Prospective study.
Materials:
One hundred and eleven consecutive patients (142 legs) with primary, uncomplicated varicose veins.
Methods:
Legs were examined clinically, with HHD and duplex ultrasonography on the same day at the outpatient clinic. The plan for the subsequent treatment was recorded separately after each examination.
Results:
At the sapheno-femoral junction and at the sapheno-popliteal junction, the sensitivity was 56 and 23%, the specificity 97 and 96%, the positive predictive values was 98 and 43%, the negative predictive value was 44 and 91%, and the Kappa coefficient was 38 and 24%, respectively. Clinical examination failed to correctly plan the treatment in 21 (26%) of 80 proposed operations. In 13 limbs (9.1%) the HHD-based treatment plan was modified on the basis of duplex ultrasound findings. In seven cases, patients would have undergone only stab avulsion procedure, whereas stripping of a saphenous vein was indicated on the basis of duplex ultrasound findings. In two other cases, HHD findings would have led to resect the wrong saphenous vein. In six cases, the treatment was wrongly planned because of assessment problems during HHD examination at the popliteal fossa.
Conclusions:
The accuracy of HHD in the preoperative evaluation of primary, uncomplicated varicose veins is unsatisfactory. These results suggest that duplex ultrasonography should be considered as the preoperative diagnostic method of choice.
Related Concept Videos
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:30Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:26Varicose Veins I: Introduction