IS THE NORMAL LIMB NORMAL IN UNILATERAL VARICOSE-VEINS

Objective: To define venous function in the clinically normal limb of patients with unilateral primary varicose veins. Design: Prospective study using duplex scanning and photoplethysmography (PPG) as objective criteria of venous function. Setting: The Middlesex Hospital Vascular Laboratory, a teaching hospital centre of referral for the investigation of venous disease. Patients: Thirty patients with clinical unilateral primary varicose veins. Results: All clinically abnormal limbs had abnormalities on investigation. However, four of 30 patients (13%) also had abnormal duplex findings on the contralateral clinically normal limb, and six (20%) had abnormal PPG refilling times. A total of 26% clinically normal limbs could be demonstrated to have some abnormality of venous function using these two tests. Conclusions: We have shown that the contralateral, clinically normal limb cannot be assumed to be normal without full formal venous assessment.