Preoperative Colour-Coded Duplex Examination of the Saphenopopliteal Junction in Recurrent Varicosity of the Short Saphenous Vein

Abstract

Undetected anatomical variations of the short saphenous vein (SSV) are a major contributing factor to recurrent varicose veins in the SSV area. Peroperative venography and varicography of the SSV have been proposed as a means of exact localization of its termination. The present study evaluated whether colour-coded duplex (CCD) examination constituted a reliable alternative for localization of the saphenopopliteal (SP) junction. Between 1989 and 1990, 12 patients were reoperated on after previous classical ligation of the SSV. Preoperative CCD examination revealed an abnormally high SP junction with persistent reflux in 11 patients and a Giacomini vein in one patient. When comparing these results with venographic and operative findings an accuracy of 100% was reached in these specific cases. It is concluded that for patients with recurrent varicosis of the SSV preoperative CCD examination provides a reliable non-invasive alternative for venography in the exact localization of the SP junction.

Keywords

short saphenous vein recurrent varicose veins colour coded duplex

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References

Mitchell

Darke

. The assessment of primary varicose veins by Doppler ultrasound — the role of sapheno-popliteal incompetence and the short saphenous system in calf varicosities. Eur J Vasc Surg 1987; 1: 113–15.

Hobbs

. Surgery and sclerotherapy in the treatment of varicose veins. A random trial. Arch Surg 1974; 109: 793–6.

Doran

Bankat

The management of recurrent varicose veins. Ann R Coll Surg Engl 1981; 63: 432.

Thomas

Chan

Anatomical variations of the short saphenous vein: a phlebographic study. Vasa 1988; 17: 51–5.

Hobbs

. Errors in the differential diagnosis of incompetence of the popliteal vein and short saphenous vein by Doppler ultrasound. J Cardiovasc Surg (Torino) 1986; 27: 169–74.

Gilliland

Gerber

Lewis

. Short saphenous vein surgery, preoperative Doppler ultrasound marking compared with on-table venography and operative findings. Phlebology 1987; 2: 109–14.

Sheppard

The incidence, diagnosis and management of saphenopopliteal incompetence. Phlebology 1986; 1: 23–32.

Vasdekis

Clarke

Hobbs

Nicolaides

. Evaluation of non-invasive and invasive methods in the assessment of short saphenous vein termination. Br J Surg 1989; 76: 929–32.

Megret

Comparative study of the clinical examination and the ultrasound scan examination of the short saphenous vein: with reference to 191 cases

Phlebologie 1985; 38: 469–73.

10.

Sugrue

Stanley

Grouden

Feeley

Moore

Shanik

. Can pre-operative duplex scanning replace pre-operarive short saphenous venography as an aid to localizing the sapheno-popliteal junction? Phlebologie 1988; 41: 722–5.

11.

Engel

Davies

Keeman

. Preoperative localization of the saphenopopliteal junction with duplex scanning. Eur J Vasc Surg 1991; 5: 507–9.

12.

Koyano

Sakaguchi

Selective stripping operation based on Doppler ultrasonic findings for primary varicose veins of the lower extremities. Surgery 1988; 103: 615–19.

13.

Leather

Leopold

Kupinski

. Preoperative mapping of the saphenous vein. In: Bernstein

, ed. Noninvasive Diagnostic Techniques in Vascular Disease. St Louis: C.V. Mosby Company, 1990: 213–18.

14.

Goren

Yellin

. Ambulatory stab evulsion phlebectomy for truncal varicose veins. Am J Surg 1991; 162: 166–74.

15.

Perrin

Chirurgie des varices essentielles des membres inférieurs. Encyclopedie Médico-Cbirurgicale, Paris. Techniques Chirurgicales, Chirurgie Vasculaire, 4.2.11, 43160.

16.

van Bemmelen

Bedford

Beach

Strandness

. Quantitative segmental evaluation of venous valvular reflux with duplex ultrasound scanning. J Vasc Surg 1989; 10: 425–31.