Balloon assisted Valsalva maneuver in the diagnosis of saphenofemoral junction incompetence

Abstract

© 2014, Medical Association of Thailand. All rights reserved. Background: Conventional Valsalva maneuver (CV) is a standard procedure to exhibit reverse venous flow at saphenofemoral junction (SFJ) by duplex ultrasonography (DUS). However, some patients could not undergo CV during examination. Objective: Compare blowing party balloon assisted Valsalva (PBAV) with CV for exhibiting the reverse venous flow at SFJ incompetence. Material and Method: Forty patients who had symptoms and signs of suspected saphenofemoral junction incompetence were examined for venous reflux by DUS with two techniques of Valsalva maneuver, PBAV, and CV. The design was a 2x2 cross-over study. The patients were randomized to two sequences. The first sequence performed CV before PBAV. The second sequence performed PBAV before CV. The timing for the instruction, reflux time, and total timing of examination were compared between the two sequences. Results: There was neither period effect nor treatment-period interaction. Both PBAV and CV could equally identify SFJ reflux, but teaching time and total examination time in PBAV was shorter than CV. Conclusion: PBAV is a new option to exhibit reverse venous flow at SFJ by DUS. PBAV is easier and spend less time than CV.