Abstract
Investigation of the deep venous system of the lower limb must mainly aim to elucidate
its capabilities. Because deep venous incompetence is necessarily connected with a
popliteal reflux accounted for by valvular incompetence of the popliteal vein, its
presence must be clarified. Priority is given to the noninvasive Doppler ultrasound
and/or duplex, and the investigation can be continued by venous pressure measurements
and phlebography only when required.
An operation in the deep veins is admissible only when a popliteal reflux of more
than 40%, an ambulatory venous pressure of more than 60 mm Hg, a refilling time less
than fifteen seconds, a venous insufficiency of more than 20%, and a patency or recanalization
of the deep veins of more than 70% have been confirmed.
A correlation between venous pressure and Doppler recordings has been done. In a series
of 81 patients (103 limbs) operated on during the last five years, the selection for
operation was made successfully only by Doppler ultrasound, as demonstrated by the
results obtained after the substitute valve operation by Technique II.
