Clin Ter. 2026 Jan-Feb;177(1):31-37. doi: 10.7417/CT.2026.1972.
ABSTRACT
BACKGROUND: Varicose veins represent a frequent vascular disorder leading to chronic venous insufficiency, with accurate localization of incompetent saphenofemoral junction (SFJ) and perforators being essential for surgical planning and prevention of recurrence. While bedside clinical tests have traditionally been used, Doppler ultrasonography is increasingly considered more reliable. This study was undertaken to compare the diagnostic accuracy of clinical evaluation and Doppler ultrasound in identifying incompetent SFJ and perforators, using intraope-rative findings as the reference.
METHODS: A prospective comparative study was carried out on 100 patients with symptomatic primary varicose veins between June 2022 and May 2024 at a tertiary care hospital. Each patient underwent detailed clinical examination using standard tests followed by Doppler ultrasound assessment. All cases subsequently proceeded to surgery, where intraoperative findings served as the gold standard. Diagnostic performance was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
RESULTS: For SFJ incompetence, both clinical assessment and Doppler ultrasound achieved 100% sensitivity, specificity, PPV, and NPV when compared with operative findings. In contrast, for perforator incompetence, Doppler demonstrated higher diagnostic accuracy (sensitivity 97.4%, specificity 50%, PPV 97.4%, NPV 50%) compared with clinical examination (sensitivity 95.1%, specificity 50%, PPV 93.6%, NPV 57.1%).
CONCLUSION: Clinical examination remains dependable for identifying SFJ incompetence; however, Doppler ultrasound provides greater accuracy in detecting perforator incompetence. Incorporating Doppler routinely in preoperative evaluation can improve localization of incompe-tent veins, optimize surgical outcomes, and reduce recurrence rates in varicose vein management.
PMID:41525111 | DOI:10.7417/CT.2026.1972