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TEST FOR INCOMPETENT COMMUNICATING BRANCHES IN THE SURGICAL TREATMENT OF VARICOSE VEINS

Gerald H. Pratt, M.D.
JAMA. 1941;117(2):100-101. doi:10.1001/jama.1941.72820280003006a.
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Before one decides which type of treatment the patient who has varicose veins is to undergo, certain tests must be performed. These are:

1. Test for the adequacy of the arterial circulation: The history of arterial competence, freedom from rubor on dependence or pallor on elevation, the palpation of the dorsalis pedis and posterior tibial arteries and the oscillometric readings.

2. Tests for the adequate functioning of the deep venous circulation (modified Perthes test): The leg is elevated and the veins are emptied. A tourniquet is applied to the upper thigh to constrict the saphenous vein return flow. The patient then walks around the room for five minutes. Absence of pain in the calf or definite swelling of the foot and ankle indicates patent deep veins.

3. Test for competence of the saphenous femoral valve (modified Trendelenburg test): The leg is elevated and the veins are emptied. The tourniquet is

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