Purpose: The purpose of this study was to assess the sensitivity of a new duplex ultrasonography method with compressing of the popliteal vein for diagnosis of medial calf incompetent perforating veins compared with conventional calf milking method (milking method).
Method: We considered that continuous retrograde flow could be detected in the incompetent perforating veins under popliteal vein compressing method (compressing method). We assessed 99 calf perforating veins greater than 1.8 mm size (Boyd: 19, Cockett: 80) in 81 legs of 75 consecutive patients.
Results: The retrograde flow was detected in 17 legs (17.2%: median diameter 3.1 mm) with both the milking method and the compressing method, in 31 legs (31.3%: 2.7 mm) with the compressing method. All of the perforating veins which demonstrated reflux under the milking method were included demonstrated reflux under the compressing method. Twelve perforating veins in C3-4 (according to the CEAP classification) demonstrated reflux in 50% (6/12) under the milking method, and in 92% (11/12) under the compressing method.
Conclusion: This study has suggested that the popliteal vein compressing method is more sensitive than the milking method for diagnosis of medial calf incompetent perforating veins.
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