Doppler examination vs clinical and phlebographic detection of the location of incompetent perforating veins: a prospective study
T. F. O'Donnell Jr, K. G. Burnand, G. Clemenson, M. L. Thomas and N. L. Browse
Accuracy in excess of 80% has been claimed both for ultrasound and for
phlebographic localization of incompetent perforating veins (ICPVs). To
test these claims, a blind prospective study was carried out to compare
three methods of simultaneous ICPV detection with operative findings. ICPV
localization on the medial side of 39 legs was made by clinical
examination, ultrasound, and ascending phlebography, each by a different
observer. The ICPVs were confirmed at operation. All three methods were
comparable in their accuracy in predicting the anatomical site of ICPVs.
Phlebography produced fewer (seven) and ultrasound more (49) false-positive
results than clinical examination did. There was no specific advantage of
ultrasound over clinical examination. The advantages of phlebography, (1)
fewer unnecessary explorations and (2) assessment of the status of the deep
venous sytem, must be weighed against its cost and morbidity.
