Accuracy of Handheld Continuous - Wave Doppler Ultrasound in the Assessment of Varicose Veins.
- Author:
Siow LR
;
Naresh G
;
Kosai NR
;
Harunarashid H
;
Sutton PA
;
Zainal AA
- Publication Type:Journal Article
- Keywords:
Varicose veins;
continous-wave Doppler;
duplex
- From:Journal of Surgical Academia
2015;5(2):16-28
- CountryMalaysia
- Language:English
-
Abstract:
The incidence of varicose veins and the need for treatment has shown a tremendous increase over the years.
Debilitating venous ulcers and dragging edemas of the lower limb with overall improvement in cosmetic results and
availability of endovenous procedures has brought many patients forward for treatment. Continuous-wave handheld
Doppler usage is limited by its diagnostic capabilities, thus the need to determine its real effectiveness. Benefits of
using hand-held dopplers lies in its rapidity in assessment of patients, it's low running cost and short learning curve.
This is important as duplex ultrasounds are not readily available in district hospitals. This study aims to determine
the clinical effectiveness of hand-held continuous wave dopplers in the local setting especially in primary
uncomplicated varicose articles veins. All electively referred patients with primary uncomplicated varicose veins
who were referred to the Varicose Vein Clinic were evaluated with continuous-wave handheld Doppler (CWD) and
duplex ultrasound (DUS) examination. The study duration was from the 1st of July to 31st of August 2013 (2
months). All patients in the study were independently evaluated with CWD and DUS in the clinic on the same day
after adequate rest time. DUS was taken as the gold standard for evaluation of CWD specificity and sensitivity. The
Chi-square and T-test was used to test for statistical significance. A total of 41 patients were evaluated in this study.
The specificity of CWD when compared to DUS for diagnosing Sapheno-femoral junction (SFJ) was 100% and at
the Sapheno-popliteal junction (SPJ) was 87%. Meanwhile sensitivity of CWD for SFJ was 75% and SPJ was 60%.
The examination time with CWD was significantly faster than when compared with DUS examination with
significant faster tracing times that can be achieved with CWD. CWD also significantly shorter reflux times when
compared to DUS. Continuous-wave handheld doppler proves to be an indispensable clinical tool in the evaluation of
SFJ and SPJ reflux in varicose veins. CWD assessment in this study was shown to be equal if not better for
evaluating reflux when compared to DUS assessment for SFJ reflux. Main advantages for CWD also lie in its low
running cost, rapidity in assessment and short learning curve when compared to duplex ultrasound examinations.
- Full text:P020151209596655310633.pdf
