Estudo comparativo entre os achados do exame físico, do mapeamento com eco-color doppler e da exploração cirúrgica na recidiva das varizes de membros inferiores a partir da junção safeno-femoral

Abstract

Background: Recurrent varicose veins of the lower limbs are a frequent complication of saphenous vein stripping and their incidence may reach 80% of the cases. Objective: To evaluate the sensitivity of physical examination and color-Doppler flow mapping for the diagnosis of insufficiency in the greater saphenous vein stump in patients who had previously undergone saphenous vein stripping, comparing the results with the findings at reoperation of the saphenofemoral junction. Methods: This prospective study included 37 limbs of 30 patients who had been previously submitted to saphenous vein stripping to treat varicose veins. Color-Doppler flow mapping was performed in all patients. Results were compared with findings at reoperation of the saphenofemoral junction. Results: The sensitivity of color-Doppler flow mapping was 70.3% (26 limbs out of 37 limbs) and false negative results occurred in 11 (29.7%) limbs (p=0.03). The sensitivity of finding varicose veins in the groin and/or in the anteromedial aspect of the upper thigh was 100% (37 limbs out of 37 limbs), without false-negatives. Conclusions: In patients previously submitted to saphenous vein stripping, recurrent varicose veins found at physical examination in the groin or anteromedial aspect of the upper thigh are suggestive of greater saphenous vein stump insufficiency. Color-Doppler flow mapping should be performed for an adequate saphenofemoral junction reoperation.