In the classic three-tourniquet (multiple tourniquet) test for varicose veins, the patient lies down with the leg elevated, a tourniquet is applied just below the saphenofemoral junction, and the patient then stands. The varicosities do NOT fill while the tourniquet remains in place. What does this indicate?

• A Incompetent communicating (perforator) veins are the main source of filling
• B Deep venous obstruction is present
• C Saphenofemoral junction incompetence is the main source of filling ✓
• D The varicosities arise from incompetent short saphenous territory only

Explanation

If a tourniquet at the saphenofemoral junction prevents refilling on standing, blood was entering the varicosities retrogradely through the long saphenous system, confirming saphenofemoral incompetence as the source. Filling that persists despite the tourniquet implies blood enters through incompetent perforators below the tourniquet. The test is largely historical since duplex ultrasound is now standard, but its logic remains examinable and maps directly onto the duplex findings.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.