Pulsating varicose vein is due to:

 # Pulsating varicose vein is due to 
A. Arterio venous fistula 
B. Sapheno femoral incompetence 
C. Deep vein thrombosis 
D. Abdominal tumour 

The correct answer is A. Arteriovenous fistula.

Communication between an artery and adjacent vein leads to arteriovenous aneurysm or arteriovenous fistula. When an arteriovenous fistula is created surgically, this is called iatrogenic arteriovenous fistula. For Renal dialysis,iatrogenic fistula is mostly used in the wrist or in the ankle and such temporary arteriovenous fistula is known as Cimino fistula. Presence of a pulsating thrill over the site of the lesion is quite characteristic, particularly if the lesion is located near the surface. If a finger is pressed on the artery proximal to the fistula,there will be slowing of pulse rate and rise in the diastolic pressure. This is known as Branham's sign.

Ref: S. Das Manual of Surgery, 3rd ed 194

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