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Duplex scanning for recurrent varicose veins
1St George Non-Invasive Vascular Laboratory, Kogarah, New South Wales, Australia.
The Australian and New Zealand Journal of Surgery
|September 1, 1996
Summary
Duplex scanning effectively identifies recurrent varicose veins, revealing the saphenofemoral junction and long saphenous vein as primary causes. Calf perforator and gastrocnemius vein issues are less significant in recurrence.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Phlebology
Background:
- Recurrent varicose veins are often assessed clinically, surgically, or via phlebography.
- Hand-held Doppler has been used, but duplex scanning offers a more advanced method for evaluating recurrent varicose veins.
Purpose of the Study:
- To analyze the patterns of recurrence in varicose veins using duplex scanning.
- To determine the primary and secondary sites of venous incompetence contributing to recurrence.
Main Methods:
- A retrospective analysis of 202 patients (267 legs) with recurrent varicose veins.
- Data collected between January 1990 and December 1995 at St George Vascular Laboratory.
- Utilized duplex scanning to assess venous anatomy and incompetence patterns.
Main Results:
- Six recurrence patterns accounted for 95.2% of cases, with saphenofemoral junction and long saphenous vein incompetence being most frequent (44.6%).
- Incompetent thigh perforators and intact long saphenous veins (16.5%) and intact incompetent long saphenous veins without saphenofemoral junction involvement (10.5%) were also significant.
- Incompetent calf perforators (69.2%) and gastrocnemius veins (9.3%) were common but rarely the sole cause of recurrence.
Conclusions:
- Duplex scanning is crucial for defining incompetence pathways in recurrent varicose veins.
- The saphenofemoral junction and long saphenous vein are key factors in varicose vein recurrence.
- Calf perforator and gastrocnemius vein incompetence play a secondary role in recurrent varicose veins.