Arteriovenous shunting in varicose veins. Its diagnosis by Doppler ultrasound flow detector.

The use of the Doppler ultrasound detector is described for the diagnosis of arteriovenous (AV) shunting in varicose veins. This investigation was carried out in 34 patients, 27 women and seven men. A total of 68 limbs with varicose veins and 48 control limbs with either no varicose veins or occlusive arterial disease are the basis for the clinical material. Twenty patients had had no prior surgery for their varicose veins and 14 had recurrent varicosities after bilateral ligation and stripping. Five patients had postphlebitic syndrome associated with varicose veins. All five had venous stasis ulcerations and edema. The Doppler flow detector uncovered AV shunting in areas outside the location of known arterial pulsations. The pulsatile venous flow was obtained at sites of "hot spots" and along markedly dilated veins. Maximum AV shunting was found in the lower third of the leg but much less often in the upper leg or thigh. The clinical implications of the role of AV shunting are discussed. The Doppler ultrasound findings appear to offer a simpler method to detect AV shunting than serial arteriography or thermography.