Randomized clinical trial of routine preoperative duplex imaging before varicose vein surgery

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Abstract
Background: Duplex imaging is used increasingly for preoperative evaluation of varicose veins, but its value in terms of the long‐term results of surgery is not clear. Methods: Patients with primary varicose veins were randomized to operation with or without preoperative duplex imaging. Reoperation rates, clinical and duplex findings were compared at 2 months and 2 years after surgery. Results: Two hundred and ninety‐three patients (343 legs) had varicose vein surgery after duplex imaging (group 1; 166 legs) or no imaging (group 2; 177 legs). In 44 legs (26·5 per cent), duplex examination suggested a different surgical procedure than had been considered on clinical grounds; the procedure was changed accordingly for 29 legs. At 2 months, incompetence was detected at the saphenofemoral or saphenopopliteal junction (or both) in 14 legs (8·8 per cent) in group 1 and in 44 legs (26·5 per cent) in group 2 (P < 0·001). At 2 years, two legs (1·4 per cent) had undergone or were awaiting reoperation in group 1, and 14 legs (9·5 per cent) in group 2 (P = 0·002). In the remainder, major incompetence was found in 19 legs (15·0 per cent) in group 1 and in 53 (41·1 per cent) in group 2 (P < 0·001). Conclusion: Routine preoperative duplex examination led to an improvement in results 2 years after surgery for patients with primary varicose veins. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Funding Information
  • Stockholm Country Council