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Abstract
Clinical methods and directional Doppler velocimetry applied to superficial veins
have been used to study 527 patients with venous disorders in the lower limbs. Phlebography
assisted by the image intensifier has been carried out in 80 of these patients. All
examinations have been done with the patient upright, exercising, and without use
of any artefact, such as a tourniquet. By these combined means Doppler flow patterns
in the superficial veins of five groups of patients have been identified: (1) a highly
distinctive downward flow in the upright exercising patient (retrograde circuit) in
simple incompetence of the superficial veins (82.1%); (2) a characteristic pattern
of upward flow accentuated by exercise, indicating collateral function past deep veins
impaired by previous thrombosis (postphlebitic syndrome) (5.7%); (3) a surge back
and forth on exercise in patients with valveless deep veins, probably of cogenital
origin (8%); (4) sustained upward flow, accentuated by exercise, in veins acting as
collaterals to occluded iliac veins (1.5%); (5) a variety of flow patterns in congenital
states, including Klippel-Trenaunay syndrome (2.7%). Approximately one half of patients
with venous stasis were in the first group and therefore probably had curable conditions;
the remainder had the deep vein problems. The incidental role of the “perforator”
is discussed and attention drawn to the significance of the retrograde circuit based
upon the foot. The directional Doppler flowmeter provides an important screening test
that positively identifies simple superficial vein incompetence, suitable for treatment,
or gives clear warning of unsatisfactory deep veins that should be investigated further.
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Article info
Publication history
Accepted:
September 28,
1982
Identification
Copyright
© 1983 Published by Elsevier Inc.
