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Lawrence M. Hanrahan, MD; Gregory J. Kechejian, MD; Paul R. Cordts, MD; Agustin A. Rodriguez, MD; Clifford A. Araki, PhD; Wayne W. LaMorte, MD, PhD; James O. Menzoian, MD

Arch Surg. 1991;126(6):687-691.

Abstract
• The nature and distribution of venous disease surrounding the development of varicose veins and its treatment is controversial. Using duplex ultrasonography, we evaluated 54 lower extremities in 32 patients with varicose veins who were symptomatic and had obvious varicose veins by clinical examination. Twenty-eight percent had greater saphenous trunk incompetence, 2% had lesser saphenous trunk incompetence, and 96% had branch disease. Deep valvular incompetence was seen in 41%, saphenofemoral junction incompetence in 46%, and incompetence of one or more perforators in 46% of the extremities. Thirty-three percent demonstrated no evidence of associated saphenofemoral junction, deep vein, or perforating vein incompetence, while 20% had concurrent saphenofemoral junction, deep vein, and perforating vein incompetence. These data support the heterogeneity of venous disease seen in patients with varicose veins and suggest that surgical therapy be directed to a patient's specific pattern of incompetence rather than routine saphenofemoral junction ligation or stripping of the greater saphenous trunk.

(Arch Surg. 1991;126:687-691)

Author Affiliations
From Boston (Mass) University Medical Center.

Footnotes
Accepted for publication February 28, 1991.

Read before the 71st Annual Meeting of the New England Surgical Society, Newport, RI, September 14, 1990.

Reprint requests to Department of Surgery, D-5, Boston University Medical Center, 88 E Newton St, Boston, MA 02118 (Dr Menzoian).

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