How is the Trendelenburg test performed to assess venous insufficiency?

Updated: Sep 25, 2020
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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To perform this test, elevate the patient’s leg until all of the congested superficial veins collapse. Apply direct pressure to occlude the superficial veins below the point of suspected reflux from the deep system into the superficial varicosity. Most often, the GSV is manually occluded just below the saphenofemoral junction at the groin.

With the occlusion still in place, have the patient stand. If the distal varicosity remains empty or fills slowly, quickly remove the occluding hand or tourniquet. If the slow filling observed with occlusion is followed by rapid filling after the occlusion is removed, the principal high-pressure entry point into the superficial system is correctly identified.

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