What test is used to differentiate between saphenofemoral valve incompetence and perforator vein incompetence?

The Brodie-Trendelenburg test is utilized to differentiate between saphenofemoral valve incompetence and perforator vein incompetence due to its specific methodology in assessing venous valve function. In this test, the physician elevates the leg to drain venous blood, then applies a tourniquet to occlude the superficial veins in the thigh. After releasing the tourniquet, the clinician observes how quickly the veins refill.

If the veins refill rapidly, it suggests saphenofemoral valve incompetence, indicating that the problem lies at the junction of the superficial and deep venous systems. Conversely, if the veins fill slowly, it points to intact saphenofemoral function but suggests that perforator veins might be incompetent.

This makes the Brodie-Trendelenburg test a practical, non-invasive method to identify where the venous insufficiency originates, guiding further management of conditions such as varicose veins or chronic venous insufficiency.