value of selection and comparison of two lines of treatment of primary varicose veins [using coloured duplex scan]

ABSTRACT

Rational treatment of superficial venous disease requires delineation of points of reflux. However, a considerable controversy exists over the need to strip the great saphenous vein [GSV] in treatment of primary varicose veins [PVV]. This study evaluated and compared the value of physical examination, Doppler ultrasonography and colored duplex scanning in selecting patients with PVV due to reflux of sapheno-femoral junction [SFJ]. Also, the benefit of SFJ ligation alone versus SFJ ligation plus stripping of the GSV in treatment of PVV due to reflux of SFJ, was compared. A total number of 102 limbs in 82 patients were initially evaluated, and selected group of 78 limbs in 62 patients were divided into group A [42 limbs] who had SFJ ligation plus GSV stripping and group B [36 limbs] who had SFJ ligation alone. Both physical examination and Doppler ultrasonography proved to be specific [100%], but less sensitive [52.6% and 74.3%, respectively] in diagnosing reflux of SFJ compared to duplex scanning. The postoperative follow up scans showed a significant superiority of stripping the GSV plus SFJ ligation in abolishing any residual reflux after operation