Duplex Scanning of Recurrent Varicose Veins

Abstract

Successful treatment of recurrent varicose veins depends on accurate assessment of the cause. Clinical examination with knowledge of previous treatment and Doppler assessment should detect most causes. Previously venograms for vulval veins, short saphenous disease and unusually distributed veins have helped. Experience with B-mode ultrasound for several years, duplex scanning for 18 months, and the manufacture of standoffs, has enabled us to examine veins from the inferior vena cava to very superficial varicosities. Previous research on vulval varicose veins has been re-examined by duplex scanning, but the evaluation of pelvic veins is more difficult. While the round ligament and male varicocele can be reasonably assessed, the preoperative assessment of the sapheno–femoral and sapheno–popliteal junctions is so accurate that it has supplanted the use of venograms. The study of Doppler wave forms to assess valve function and the detection of reversed flow, should also help in further studies on chronic venous insufficiency and perforating vein disease.