2002 Volume 13 Issue 1 Pages 11-15
Interruption of incompetent perforating vein (PVs) is important for varicose vein surgery. Duplex ultrasonography (US) is today widely used for the preoperative evaluation of varicose veins. In this study, we mentioned the pre and intraoperative diameter-reflux relationship of PVs in patients with varicose veins.
A total 324 calf PVs was detected in 304 legs in 175 patients with varicose veins. Diameters of competent and incompetent PVs (mm) defined by US averaged 2.45±0.17 and 3.40±0.13 at the upper calf, 2.84±0.12 and 3.68 ±0.08 at the lower calf and 2.64±0.21 and 3.40±0.15 at the posterior calf, respectively. During the operation, the incompetence of each PVs were judged by manual milking of the distal portion of the PV, and reflux was defined as spurt of blood from the stump of the disconnected PVs. Diameters of competent and incompetent PVs (mm) diagnosed by the intraoperative finding averaged 2.67±0.21 and 3.23±0.13 at upper calf, 2.85±0.12 and 3.68±0.08 at the lower calf and 2.67±0.27 and 3.27±0.14 at the posterior calf, respectively. Based on the operative findings, overall sensitivity of detecting the incompetence by US was 87.7%, and the specificity was 75.3%. Diameters of true incompetent PVs and false incompetent PVs were 3.59±0.07 mm and 3.31±0.17 mm. Diameters of true competent PVs and false competent PVs (mm) were 2.61±0.11 and 2.89±0.16, respectively.
Although the diameter of incompetent PVs is larger than that of competent PVs in both US and intraoperative finding, diameter measurement can not solely distinguish competent PVs from incompetent PVs by US. To achieve more accurate diagnosis of incompetent PVs, additional methods may be needed.
