Abstract
Objective
The aim of the study is to assess various reflux sites in patients with varicose veins by using duplex scan.
Patients and Methods
This prospective observational study was done at Department of Diagnostic Radiology, Holy Family Hospital, Rawalpindi in collaboration with Department of Surgery, Social Security Hospital, Islamabad from January 2007 to December 2010. All the patients diagnosed as having varicose veins by the surgeon and referred to the department of radiology underwent duplex scanning of the venous system of the affected lower limb. The patients having recurrent varicose veins, history of limb trauma, previous venous surgery, sclerotherapy, and deep venous thrombosis were excluded from the study. The long and short saphenous systems were assessed, together with the deep veins and perforators along the medial aspect of the thigh and calf. Reflux was defined by retrograde flow lasting longer than 0.5 s after manual calf compression.
Results
A total of 128 lower limbs of 114 patients were included in the study. 71 (62.28%) were males and 43 (37.72%) were females. Mean age was 44.67 years (range 22-63). Mean age of male was 42.06 years and that of females was 48.53 years. Of the 128 lower limbs assessed, 68 were right, 60 were left and 14 patients had bilateral varicose veins. Isolated sapheno-femoral junction incompetence was found in 46 (35.9%) cases whereas isolated sapheno-popliteal junction incompetence was seen in 30 (23.4%) patients, 32 (25%) had both sapheno-femoral and sapheno-popliteal incompetence.
Conclusion
Saphenofemoral junction was the most common site of reflux in the varicose veins. As colour duplex scan is non-invasive, repeatable, and readily accepted by the patients, it should be the investigation of choice for patients presenting with varicose veins. (Rawal Med J 2011;36:305-309).

Key words: Varicose veins, doppler ultrasound, duplex scan.