Can varicectomy be performed if deep veins are occluded?

The problem of varicectomy in the setting of deep venous occlusion is discussed. A new and simple test is applied to determine if the resulting varicosity is necessary to contribute to venous circulation in the limb and if subfascial collateral pathways are sufficient to maintain it. The test is a modification of the Perthes test. Instead of a rubber-strip tourniquet, a tensiometer cuff is used with 110 mmHg for 5 minutes on a walking patient. In negative cases the superficial varicosity can be removed radically, in spite of deep venous occlusion, to decrease the venous blood loading and ameliorate the venous drainage without risk to the blood circulation.