Differntiation of primary from secondary varicose veins by Doppler ultrasound and strain gauge plethysmography.

The Doppler ultrasonic velocity detector and the strain gauge plethysmograph were used to differentiate qualitatively and quantitatively primary from secondary varicose veins. Studies were performed in 21 limbs of 14 normal persons, nine limbs of eight patients with varices secondary to deep venous disease. The latter group of patients was identified by ultrasonic evidence of venous reflux through imcompetent deep venous valves. There was no significant difference in the maximum venous outflow of the limbs of the three groups of persons as determined by plethysmography. The primary hemodynamic abnormality in patients with varicose veins was significant venous reflux through imcompetent venous valves. This reflux was obliterated by tourniquet compression of the varices in patients with primary varicose veins. However, secondary varicose veins are distinguished by persistent abnormal deep venous reflux after compression of the varices. These diagnostic techniques not only provide accurate noninvasive diagnostic information but also may facilitate determination of prognosis and therapy of patients with varicose veins.