comparison of manual compression release with distal pneumatic cuff maneuver in the ultrasonic evaluation of superficial venous insufficiency background venous reflux can be elicited either manually or by pneumatic tourniquet and previous studies did not indicate any significant difference between these manoeuvres in patients with superficial venous insufficiency svipurpose to investigate if two methods correlate in patients with cvimaterials and methods venous reflux was studied in 94 venous segments of 57 limbs in 52 consecutive patients with svi limbs were divided into two groups group i ceap c2c3 and group ii ceap c4c6 a colour duplex scanner was used to determine quantitative venous reflux at the saphenofemoral junction sfj at the saphenopopliteal junction spj and in the greater saphenous vein in the thigh gsv patients received both manual compression and cuff deflation method in eliciting venous reflux the parameters assessed were the duration of reflux second and the peak reflux velocity cmsstatistics paired ttest was used to evaluate differences between the two methods statistical significance was recorded when the pvalue was 005 bland and altman plot was also used to assess the agreement of the same measurementresults there were 58 venous segments in group i and 36 in group ii in group i there were no significant differences in the duration of reflux at the sfj spj and in the gsv on the contrary peak reflux velocity was found to be significantly higher at the sfj and in the gsv p0022 and 0006 respectively in group ii there was no significant difference in the duration of reflux at the sfj and spj between the two methods on the contrary manual compression maneuver produced significantly higher peak reflux velocity than at the sfj and in the gsv p0023 and 0002 respectively bland and altman plot analysis manual compression method displayed a relatively good agreement with cuff deflation manoeuvre both in group i and group ii in contrast concerning the peak reflux velocity relative wide limits of agreement were found between the two methodsconclusions unlike previously published reports our results lead to apparent discrepancies in the quantitative evaluation of venous reflux using different methodology