DUPLEX SONOGRAPHIC EVALUATION OF THE SAPHENOFEMORAL VENOUS JUNCTION IN PATIENTS WITH RECURRENT VARICOSE-VEINS AFTER SURGICAL-TREATMENT

Purpose. We used duplex sonography in patients with recurrent varicose veins after surgical treatment to detect any residual stump of the gr eat saphenous vein at the sapheno-femoral venous junction, and we comp ared these sonographic findings with surgical findings as the ''gold s tandard.'' Methods. We prospectively studied 65 patients (54 women and 11 men) who had recurrent varicose veins 1-30 years (mean, 11 years) after surgical exploration of the groin and ligature of the great saph enous vein at its junction with the femoral vein. Duplex scans were pe rformed in all patients before surgical reexploration. Sonographic fin dings were compared with surgical findings. Results. Duplex scanning r evealed a residual stump in 47 patients (72%) and no stump in 15 patie nts (23%). Thirty-five (74%) of the 47 cases with a residual stump had reflux on duplex scans, and the remaining 12 cases (26%) showed no re flux, Findings in all 62 of these cases were confirmed by surgery. In only 3 patients (5%) did duplex scans fail to show a residual stump wh en surgery revealed a small residual stump without reflux. Conclusions . Duplex scanning is the noninvasive diagnostic technique of choice to detect any residual stump of the great saphenous vein and to diagnose valve failure at the sapheno-femoral venous junction in patients with recurrent varicose veins. (C) 1998 John Wiley & Sons, Inc.