PHLEBOGRAPHY IN THE MANAGEMENT OF RECURRENT VARICOSE-VEINS

Objectives: (1) To report the results of phlebography (varicography an d venography) in the identification of important venous communications in patients with recurrent varicose veins. (2) To assess whether phle bography provides additional valuable information when compared with c linical and hand-held Doppler examination. Design: Retrospective revie w. Setting: Vascular unit, district general hospital. Patients: A cons ecutive series of 46 patients attending with recurrent varicose veins. Interventions: Clinical examination, hand-held Doppler, venography an d varicography. Main outcome measures: (1) Sites of incompetent venous communications. (2) Assessment of value of preoperative phlebography when compared with clinical and hand-held Doppler examination. Results : Sixty-four venograms were performed on 46 patients of mean age 52 ye ars, range 30-81 years. Calf perforator (88%) and mid-thigh perforator incompetence (38%) were common. Groin recurrence (33%) included examp les of neovascularization, inadequate previous surgery and inadequate assessment, Popliteal recurrence (34%) secondary to incompetent gastro cnemius, popliteal fossa and short saphenous veins also present. Preop erative phlebography supplied valuable additional information in 75% o f patients. Conclusion: Phlebography of recurrent varicose veins provi des useful information supplementary to that furnished from clinical e xamination alone.