Australia & New Zealand Society of Vascular Surgeons

Introduction A high incidence of patients presenting with recurrent varicose veins defined the need for surgery to be improved. The new availability of colour duplex ultrasound in 1990 provided a reliable, non-invasive means of investigating varicose veins prior to surgery. Methods Duplex venous scanning, with both ultrasonographer & surgeon present, commenced in September 1990. Bilateral limb scans were performed in all studies and now take approximately 20 minutes. Over 750 studies have been undertaken to date. Results Anatomy of presentation of varicose veins was variable. Variance from clinical examination or confirmation of atypical anatomy was noted in over 25% of patients. For patients with recurrence causes included evidence of neovascularization at the sapheno-femoral junction, non-stripping of incompetent long saphenous veins, inadequate previous surgery and probable failure to recognise and treat all primary causes of patient’s varicose veins. For primary varicose veins results indicated the potential to tailor surgery to the defined venous incompetence. Conclusions Ensuring accurate assessment of the anatomy of an individual patient’s varicose veins may enable surgery to be tailored to individual needs and reduce the incidence of recurrence.