A comparison of colour duplex ultrasound with venography and varicography in the assessment of varicose veins.

Ninety-three legs in 68 consecutive patients presenting for preoperative assessment of varicose veins were examined by a combination of ascending venography with varicography and also by colour duplex ultrasound. Ninety-one to ninety-two per cent of incompetent sapheno-femoral and sapheno-popliteal communications were demonstrated by ascending venography/varicography and 92-95% by ultrasound. Ascending venography/varicography demonstrated 83-90% of incompetent perforators whilst ultrasound demonstrated only 40-63%. We conclude that ultrasound is an accurate method of assessing primary and recurrent sapheno-femoral and sapheno-popliteal incompetence but is of limited value in assessing perforator incompetence. This is a significant limitation of ultrasound in view of the importance of perforator disease, and it is likely that this technique can only be used in combination with other venographic methods.