A study to compare the usefulness of a careful clinical examination with venous Doppler studies in patients with varicose veins
DOI:
https://doi.org/10.18203/2349-2902.isj20181841Keywords:
Doppler study, Varicose veins, Incompetent perforating veinsAbstract
Background: The significance of recognizing and locating incompetent perforating veins for treating the patients with varicose vein and venous ulcers is well established. Several methods of diagnosing incompetent perforating veins have been evaluated in the past, however, none show satisfactory accuracy in predicting incompetent perforating veins. Clinical examination with digital palpation of fascial defects is the most widely used method. These fascial clefts are generally thought to keep up a correspondence to incompetent perforating veins. Further evidence is obtained when digital pressure relief on the defect leads to filling of superficial varicose veins or if a tourniquet applied beneath the defect prevents it. The purpose of the present study was to compare clinical examination with that of Doppler venous study in the diagnosis of incompetent perforating veins of lower limbs.
Methods: T This is a Cross-sectional comparative study which was carried out in 34 (13 women, 21 men) patients with lower limb varicose veins admitted to the department of general surgery in Aarupadai Veedu medical college and hospital. 38 limbs were studied in 34 patients. They were evaluated by clinical tests and Doppler ultrasound.
Results: Saphenofemoral incompetence was correctly diagnosed in all the 38 limbs both by clinical test and Doppler ultrasound. In the evaluation of perforator competency, the sensitivity was 88.14% by clinical tests and 98.31% by Doppler ultrasound.
Conclusions: From this study and results, it shows that doppler ultrasound evaluation of the varicose veins should be done for accurate diagnosis in all patients before planning surgery.
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References
Almgren B, Eriksson I. Valvular incompetence in superficial deep and perforator veins of limbs with varicose veins. Acta Chir. 1990;156:69-74.
Hanrahan LM, Araki CT, Rodriguez AA, Kechejian GJ, LaMorte WW, Menzoian JO. Distribution of valvular incompetence in patients with venous stasis ulceration. J Vasc Surg. 1991;13:805-11.
Labropoulos N, Giannoukas AD, Nicolaides AN, Ramaswami G, Leon M, Burke P. New insights into the pathophysiologic condition of venous ulceration with colour-flow duplex imaging: implications for treatment? J Vasc Surg.1995;22:45-50.
O'Donnell TF, Burnand KG, Clemenson G, Lea Thomas M, Browse NL. Doppler examination vs clinical and phlebographic detection of the location of incompetent perforating veins. Arch Surg. 1977; 112:31-5.
Warwick WT. The rational treatment of varicose veins and varicocele. London: Faber and Faber, 1931: 60.
Malhotra SL. An epidemiological study of varicose veins in Indian railroad workers from the South and North of India, with special reference to the causation and prevention of varicose veins. Int J Epidemiol. 1972;1:177-83.
Dixon PM. Duplex ultrasound in the pre-operativeAustralas Radiol 199 assessment of varicose veins. 6;40:416-21.
Vashist M, Godara G, Rajesh R, Sen J, Panwar S. Management of varicose veins: Status of clinical examination and colour Doppler in the present Indian scenario. Internet J Surg. 2013;20:7613.
Kim J, Richards S, Kent PJ. Clinical examination of varicose veins- A validation study. Ann R Coll Surg Engl. 2000;82:171-5.
Seshadri R, Villavicencio JL, editors. Surgical Management of Venous Disease. USA, Baltimore: Williams and Wilkins; 1997. p. 275.
Irodi A, Keshava SN, Agarwal S, Sadhu D. Standardisation of preoperative marking of incompetent perforators and saphenopopliteal junction on Doppler with evaluation of “t” technique. Indian J Surg 2011;73:37-9.
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