[Functional indications for stripping in the treatment of varicose veins (author's transl)]

The venous pressure was measured in a dorsal foot vein with the aid of a Statham transducer and the foot volume was simultaneously registered by a water plethysmograph in 37 legs of patients with varicosis of the internal saphenous vein. 17 legs showed signs of chronic venous insufficiency of post-thrombotic syndrome. These measurements were carried out in the standing position and during standardized knee-bending exercises. They were repeated after elimination of the varicose veins by a tourniquet on the distal thigh and lower leg and between 2 and 6 weeks after a stripping operation. There was a statistically significant correlation between the functional improvement after elimination of the varicose veins by tourniquet and by operation. It is concluded that the elimination of varicose veins by compression allows a reliable prognosis of the functional gain obtained by the operation (accuracy of the prognosis for the pressure measurements: 95%, for volume measurements: 80%). The results were compared with the values in a healthy control group (n = 17), a non-operated group of patients with chronic venous insufficiency (n = 30) and a group of patients with post-thrombotic syndrome (n = 30). The investigation of the function of the calf-muscle pump and the amelioration obtained by compression of varicose veins is a helpful guide in the decision whether to operate or not on patients with chronic venous insufficiency or with post-thrombotic syndrome. A significant functional gain can be sometimes obtained in such patients after stripping, whilst in other cases, which cannot be differentiated on a merely clinical basis, bad results are reported. The described functional investigations allow a better differentiation of these alternatives than phlebography and are, therefore, recommended as routine methods in such cases.