Physical Examination, Doppler Ultrasound and Colour Flow Duplex Scanning: Guides to Therapy for Primary Varicose Veins

Objective:To compare physical examination (PE) and continuous-wave hand-held Doppler (CWD) examination with colour flow duplex scanning as a gold standard for greater saphenous vein (GSV) reflux.Design:Prospective performance of PE and CWD by two clinical examiners and subsequent duplex scanning by two vascular laboratory technicians unaware of the results of the PE and CWD examinations. Tapes were then reviewed; results of the duplex scanning were compared with physical and CWD findings.Patients:Thirty-one women and nine men, aged 27–64 years, with symptomatic class I primary varicosities in distribution of the GSV. Eighty limbs were evaluated Prospectively in 40 consecutive patients, including 22 limbs in 14 patients with a history of prior GSV stripping.Interventions:GSV ligation and stripping in 50 limbs when duplex demonstrated saphenofemoral or truncal reflux; 30 limbs were treated by stab avulsion, cluster excision and sclerotherapy.Main outcome measures:Demonstration of saphenofemoral reflux by du...