Abstract
It is an essential prerequisite of any intervention that an accurate diagnosis is made prior to that procedure. Traditionally, the surgery for venous disease has been largely focused on the management of varicose veins, with minimal or no investigation, and was associated with recurrence rates of up to 65% [1]. Whilst the aetiology of recurrent varicose veins is multifactorial, two main factors are undoubtedly linked: the accuracy of the original diagnosis and the quality of the subsequent surgery performed. Inadequate dissection by surgeons in training has also been cited. Persisting incompetence in 41% of patients following varicose vein surgery suggests that trainees perform surgery less effectively than consultants [2]. It is not too surprising that as many as 20–30% of new referrals to venous clinics are patients with recurrent varicose veins.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping of the long saphenous vein. Eur J Vasc Endovasc Surg 1996;12:442–445.
Lees T, Sing S, Beard J, Spencer P, Rigby C. Prospective audit of surgery for varicose veins. Br J Surg 1997;84:44–46.
Bradbury AW, Stonebridge PA, Ruckley CV, Beggs I. Recurrent varicose veins: correlation between preoperative clinical and hand-held Doppler ultrasonographic examination, and anatomical findings at surgery. Br J Surg 1993;80:849–851.
Sarin S, Shields DA, Farrah J, Scurr JH, Coleridge-Smith PD. Does venous function deteriorate in patients waiting for varicose vein surgery? J R Soc Med 1993;86:21–23.
Dixon PM. Duplex ultrasound in the pre-operative assessment of varicose veins. Australas Radio 1996;40:416–421.
Salaman RA, Fligelstone LJ, Wright, Pugh N, Harding KG, Lane IF. Hand-held bi-directional Doppler versus colour duplex scanning in the preoperative assessment of varicose veins. J Vasc Invest 1995;1:183–186.
McMullin GM, Coleridge-Smith PD, Scurr JH. A study of tourniquets in the investigation of venous insufficiency. Phlebology 1991;6:133–139.
Darke SG, Vetrivel S, Foy DMA, Smith S, Baker S. A comparison of duplex scanning and continuous wave Doppler in the assessment of primary and uncomplicated varicose veins. Eur J Vasc Endovasc Surg 1997;14:457–461.
Mercer KG, Scott DJA, Berridge DC. Is pre-operative duplex required in all cases of primary varicose veins? Presented at the Venous Forum of the Royal Society of Medicine, London, 1997.
Quigley FG, Raptis S, Cashman M, Faris IB. Duplex ultrasound mapping of sites of deep to superficial incompetence in primary varicose veins. Aust NZ J Surg 1992;62:276–278.
Dunning PG, Payne SPK, Banerjee B, Lees TA, Lambert D. Do all patients with varicose veins need a duplex ultrasound? Presented at the Venous Forum, Royal Society of Medicine, London, October 1997.
Campbell WB, Halim AS, Aertson A, Ridler BMF, Thompson JF, Niblett PG. The place of duplex scanning for varicose veins and common venous problems. Ann R Coll Surg Eng 1996;78:490–493.
Hoare MC, Royle JP. Doppler ultrasound detection of sapheno-femoral and sapheno-popliteal incompetence and operative venography to ensure precise sapheno-popliteal ligation. Aust NZ J Surg 1984;54:49–52.
Turton EPL, McKenzie S, Weston MJ, Berridge DC, Scott DJS. Optimising a varicose vein service to reduce recurrence. Ann R Coll Surg Engl 1997;79:451–454.
DePalma R, Hart M, Zarin L, Massarin E. Physical examination, Doppler ultrasound and colour flow duplex scanning: guides to therapy of primary varicose veins. Phlebology 1993;8:7–11.
Tong Y, Royle J. Recurrent varicose veins following high ligation of long saphenous vein: a duplex ultrasound study. Cardiovasc Surg 1995;3:485–487.
Myers KA, Ziegerhein RW, Zeng GH, et al. Duplex ultrasonography scanning for chronic venous disease: patterns of reflux. J Vasc Surg 1995;21:605–612.
Vasdekis SN, Clarke GH, Hobbs JT, Nicolaides AN. Evaluation of non-invasive and invasive methods in the assessment of short saphenous vein termination. Br J Surg 1989;76:929–932.
Kent PJ, Weston MJ. Duplex scanning is unnecessary in all patients presenting with primary, non-recurrent varicose veins. Personal communication.
Campbell WB, Niblett PG, Ridler BMF, Peters AS, Thompson JF. Hand-held Doppler as a screening test in primary varicose veins. Br Surg 1997;84:1541–1543.
Rights and permissions
Copyright information
© 1999 Springer-Verlag London Limited
About this chapter
Cite this chapter
Berridge, D.C., Weston, M.J. (1999). Should Every Patient with Chronic Venous Disease Have a Duplex Scan?. In: Venous Disease. Springer, London. https://doi.org/10.1007/978-1-4471-0829-0_20
Download citation
DOI: https://doi.org/10.1007/978-1-4471-0829-0_20
Publisher Name: Springer, London
Print ISBN: 978-1-4471-1212-9
Online ISBN: 978-1-4471-0829-0
eBook Packages: Springer Book Archive