Brodie-Trendelenburg test

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The Brodie-Trendelenburg test is used to determine the site of valvular incompetence in a patient with varicose veins.

• Ask the patient to lie down.
• Elevate the leg, and empty the veins by massaging distal to proximal.
• Using a tourniquet, occlude the superficial veins in the upper thigh.
• Ask the patient to stand. If the tourniquet prevents the veins from re-filling rapidly, the site of the incompetent valve must be above this level i.e. at the sapheno-femoral junction. If the veins re-fill, the communication must be lower down.

Observing the same protocol, proceed down the leg until the tourniquet controls re-filling. As necessary, test:

• above the knee – to assess the mid-thigh perforator

• below the knee – to assess competence between the short saphenous vein and popliteal vein

If re-filling cannot be controlled, the communication is probably by one or more distal perforating veins.

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