Brodie-Trendelenburg test

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Brodie-Trendelenburg test

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The Brodie-Trendelenburg test is used to determine the site of valvular incompetence in a patient with varicose veins.

How to perform?

  • Ask the patient to lie down.
  • Elevate the leg, and empty the veins by massaging distal to proximal.
  • Using a tourniquet, occlude the superficial veins in the upper thigh.
  • Ask the patient to stand. If the tourniquet prevents the veins from re-filling rapidly, the site of the incompetent valve must be above this level i.e. at the sapheno-femoral junction. If the veins re-fill, the communication must be lower down.

Observing the same protocol, proceed down the leg until the tourniquet controls re-filling. As necessary, test:

  • above the knee - to assess the mid-thigh perforator
  • below the knee - to assess competence between the short saphenous vein and popliteal vein

If re-filling cannot be controlled, the communication is probably by one or more distal perforating veins.

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