Late follow-up of a randomized trial of routine duplex imaging before varicose vein surgery

Br J Surg. 2011 Aug;98(8):1112-6. doi: 10.1002/bjs.7579. Epub 2011 May 27.


Background: Routine preoperative duplex examination led to an improvement in results 2 years after surgery for primary varicose veins. The aim of the present study was to evaluate the impact of preoperative duplex imaging after 7 years, in relation to other risk factors for varicose vein recurrence.

Methods: Patients with primary varicose veins were randomized to operation with (group 1), or without (group 2) preoperative duplex imaging. The same patients were invited to attend follow-up with interview, clinical examination and duplex imaging. Quality of life (QoL) was measured with the Short Form 36 questionnaire.

Results: Some 293 patients (343 legs) were included initially; after 7 years 227 were interviewed, or their records reviewed: 114 in group 1 and 113 in group 2. One hundred and ninety-four legs (95 in group 1 and 99 in group 2) were examined clinically and with duplex imaging. Incompetence was seen at the saphenofemoral junction and/or saphenopopliteal junction in 14 per cent of legs in group 1 and 46 per cent in group 2 (P < 0.001). QoL was similar in both groups. After a mean follow-up of 7 years (and including patients who underwent surgery after the review), 15 legs in group 1 needed reoperation and 38 in group 2 (P = 0.001).

Conclusion: Routine preoperative duplex imaging improved the results of surgery for primary varicose veins for at least 7 years.

Trial registration: NCT01195623.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / etiology
  • Preoperative Care
  • Quality of Life
  • Recurrence
  • Reoperation
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Varicose Veins / diagnostic imaging*
  • Varicose Veins / surgery

Associated data