[The contribution of Doppler echography in the diagnostic and therapeutic plan in chronic venous insufficiency surgery].

Abstract

Indications for duplex scan in venous surgery. Vascular surgeons are led to request Duplex Scan examination of patients with chronic venous insufficiency in a number of circumstances: A) To obtain information supporting the diagnosis and treatment plan: Chronic venous insufficiency may be due to isolated superficial venous insufficiency or (and) deep venous insufficiency (post-thrombotic syndrome, primary deep valvular insufficiency, congenital malformation). In practice, Duplex Scan examination of the deep venous system is indicated whenever the patient's history is suggestive of deep venous thrombosis or the clinical status is stage 2 or 3 (Ad Hoc Committee classification). In patients with reflux in the popliteal fossa, Duplex Scan is helpful because physical examination and Doppler cannot correctly differentiate short saphenous insufficiency, gastrocnemius insufficiency and reflux in the popliteal-tibial axis, especially as these physiopathologic mechanisms may be associated. In patients with atypical varices, Duplex Scan can demonstrate: Absence of reflux in the greater saphenous vein-femoral vein termination or the short saphenous vein-popliteal vein termination. Varices in the lateral or posterior thigh. In patients with varicose vein thrombosis, Duplex Scan can reveal: The extent of any association with deep venous system. The extent of superficial venous thrombosis. When the results of varicose vein surgery are unsatisfactory, Duplex Scan can determine whether a redo surgery is justified: Persistence of a major leak between the deep and superficial venous system usually prompts redo surgery. Less often, recurrence is due to primary deep valvular insufficiency, in which case valvuloplasty may be indicated.(ABSTRACT TRUNCATED AT 250 WORDS)