Brodie–Trendelenburg Test

Original Editor - Ashmita Patrao

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Introduction[edit | edit source]

This technique was originally described in the in 1846 by Brodi an popularized by Trendelenburg in 1891. The primary aim of this test was to identify an incompetency in the sapenofemoral junction.

Technique[edit | edit source]

The affected leg is raised so that the veins are emptied by gravity. Around the upper thigh region a tourniquet is applied, sufficiently tightly to constrict the saphenous vien. The femoral vein blood flow is'nt obstructed. The subject is then asked to stand and the degree of filling of he saphenous vein is noted.

Interpretation[edit | edit source]

If the test is negative, with the tourniquet in place the veins fill within a period of 30 seconds, ad upon removal of the tourniquet n increased rate of filling is observed. There is no retrograde flow taking place through the saphenofemoral junction, and the filling occurs due to incompetency of the communicating veins.

If the test is positive, While the patient stands with a tourniquet is placed, the varicosities will remain collapsed throughout the 30second period. Once the tourniquet is removed the internal saphenous vein rapidly fills with blood from above. This indicates that the valves of the saphenous vein at the saphenofemoral junction are incompetent, but the valves of the communicating veins are still intact.

Doubly positive, If the veins rapidly fill on standing and again as the tourniquet is removed is there is further distension of the veins. This indicates incompetency of the valves of both the saphenous and communicating systems of veins.

Nil, the tourniquet is applied and even after removal there is only slow filling of the veins from below. This indicates that both the saphenous veins and the communicating veins are competent.

Thus this test serves 2 purposes, firstly demonstrates any backward flow at the saphenofemoral junction and secondly it establishes if there are incompetent communicating veins between the deep ad superficial venous systems.[1][2][3][4]

References[edit | edit source]

  1. Steiner CA, Palmer LH. A simplification of the diagnosis of varicose veins. Ann Surg. 1948 Feb;127(2):362.
  2. Bhasin N, Scott DJ. How should a candidate assess varicose veins in the MRCS clinical examination? A vascular viewpoint. The Annals of The Royal College of Surgeons of England. 2006 May;88(3):309-12.
  3. BERGAN J. Risk Factors, Manifestations, and Clinical Examination of the Patient with Primary Venous Insufficiency. InThe Vein Book 2007 Jan 1 (pp. 119-124). Academic Press.
  4. Shilpa K, Lakshmi DV, Divya Gorur K. Evaluation of Varicose Veins. Sclerotherapy in Dermatology. 2018 May 31:29.