Role of the Ankle Pump Maneuver in the Assessment of Incompetent Calf Perforator Veins Using Duplex Ultrasound in Patients With Varicose Veins

Background: Incompetent calf perforator veins are a major contributor to chronic venous disease and recurrence of varicose veins. Aim: To evaluate the diagnostic performance of the ankle pump maneuver in detecting incompetent calf perforator veins using duplex ultrasound. Methods: A cross-sectional study was conducted on 50 patients with clinically diagnosed varicose veins. Three provocative methods were compared: manual compression in standing, manual compression in sitting, and ankle pump in sitting. Results: The ankle pump maneuver demonstrated the highest detection rate (90%) and significantly longer reflux duration compared with other methods (p < 0.001). Conclusion: The ankle pump maneuver is superior to conventional compression techniques and should be incorporated into routine venous Doppler evaluation.