CLINICAL EXAMINATION, DUPLEX ULTRASOUND AND PLETHYSMOGRAPHY FOR VARICOSE-VEINS

Objective: In pursuing a policy of selective greater saphenous vein (G SV) preservation in the treatment of varicose veins we hypothesized th at limbs with isolated tributary disease (TD) would be ideal candidate s for GSV preservation.Design: Prospective blinded series. Setting: Un iversity teaching hospital. Patients: Fifty-nine symptomatic legs in 4 5 consecutive patients presenting with varicose veins. Interventions: Patients were evaluated by physical examination, quantitative photople thysmography (QPG) and colour flow duplex examination. Main outcome me asure: Color flow duplex as the standard of comparison. Results: Of th e limbs studied, 29% had isolated TD. The sensitivity of physical exam ination for GSV incompetence was 43%, but specificity was 100%. QPG yi elded a similar sensitivity of 24% and specificity of 100%. Conclusion s: Twenty-nine per cent of limbs were optimal candidates for sparing o f the GSV with excision of branch varicosities alone. Duplex examinati on was necessary only when the GSV was clinically normal, and QPG was not helpful.