Short Saphenous Vein Surgery, Pre-Operative Doppler Ultrasound Marking Compared with on-Table Venography and Operative Findings

Abstract

Unidirectional Doppler ultrasound is a simple and inexpensive adjunct to the clinical examination of varicose veins; its accuracy in determining the level of the saphenopopliteal junction has not previously been assessed. A total of 30 limbs with saphenopopliteal reflux were examined with a portable Doppler on the day of surgery and the upper limit of reflux marked. This was compared with the findings of on-table venography and surgery. Venography provided accurate anatomical information in only 84% of cases, in the failures the Doppler mark proved useful by eliminating the need for multiple incisions. Doppler estimation of the saphenopopliteal junction was correct in only 40% of cases but in nine cases out of 10 it was within 2 cm; a distance that will allow appropriate surgery through a single incision. In experienced hands the use of unidirectional doppler may eliminate the need for pre-operative venography in selected cases.