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

Abstract

Undetected anatomical variations of the short saphenous vein are a major contributing factor to recurrent varicose veins in the saphenous vein area. Perioperative venography and varicography of the short saphenous vein have been proposed as a means of exact localization of its termination. The present study evaluated whether colour-coded duplex examination constituted a reliable alternative for localization of the saphenopopliteal junction. Between 1989 and 1990, 12 patients were reoperated on after previous classical ligation of the short saphenous vein. Preoperative colour-coded duplex examination revealed an abnormally high saphenopopliteal junction with persistent reflux in 11 patients and a Giacomini vein in one. 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 short saphenous vein, preoperative colour-coded duplex examination provides a reliable non-invasive alternative to venography in the exact localization of the saphenopopliteal junction.

Keywords

short saphenous vein recurrent varicose veins colour-coded duplex

Get full access to this article

View all access options for this article.

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. Phlébologie 1985; 38: 469–73.

10.

Sugrue

Stanley

Grouden

Feeley

Moore

Shanik

. Can pre-operative duplex scanning replace pre-operative short saphenous venography as an aid to localizing the sapheno-popliteal junction? Phlébologie 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.

van Bemmelen

Bedford

Beach

Strandness

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

13.

Koyano

Sakaguchi

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

14.

Leather

Leopold

Kupinski

. Preoperative mapping of the saphenous vein. In: Bernstein

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

15.

Goren

Yellin

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