if exists(select * from dbo.sysobjects where id = object_id(N'dbo.usp_Binary_Read') and objectproperty(id, N'IsProcedure') =  1 )
   drop procedure dbo.usp_Binary_Read
go
create procedure dbo.usp_Binary_Read
   @img varbinary( 1000 ) out
as set nocount on
   set @img = convert(varbinary( 1000 ), 'qwertyuiopasdfghjklzxcvbnm')
   return( 0 )
go

#include <comutil.h>
#include <io.h>
#include <fcntl.h>
#include <sys/stat.h>
#include <iostream>

#import "C:\Program Files\Common Files\System\ADO\msado15.dll" \
         no_namespace rename("EOF", "adoEOF")

struct ZC_COMInitialize {
  ZC_COMInitialize(){CoInitialize( 0 ); }
 ~ZC_COMInitialize(){CoUninitialize();}
}; 
ZC_COMInitialize COMInit;

int main(){
  long hFile( 0 ); SAFEARRAY  *psa; char HUGEP *ptr; _variant_t v;
  _bstr_t ConnStr = "Provider=SQLOLEDB;       \
                     Data Source=(local);     \
                     Initial Catalog=pubs;    \
                     Integrated Security=SSPI";
  _ConnectionPtr conn;
  try {
    conn.CreateInstance(__uuidof(Connection));
    conn->CursorLocation = adUseServer;
    conn->IsolationLevel = adXactReadCommitted;
    conn->Attributes     =  0 ;
    conn->Open(ConnStr,"","",adConnectUnspecified);

    _CommandPtr cmd;
    cmd.CreateInstance(__uuidof(Command));
    cmd->ActiveConnection = conn;
    cmd->CommandType      = adCmdStoredProc;
    cmd->CommandText      = "dbo.usp_Binary_Read";

    ParametersPtr pars = cmd->Parameters;
    pars->Append(cmd->CreateParameter("@RET", adInteger,   adParamReturnValue,     0 ,  0 ));
    pars->Append(cmd->CreateParameter("@IMG", adVarBinary, adParamOutput,       1000 , ""));
    cmd->Execute( 0 , 0 ,adCmdStoredProc);

    v = pars->Item[1L]->Value; 
    if(v.vt != VT_EMPTY){
      hFile = _open("c:\\temp\\img.img", _O_BINARY | _O_CREAT | _O_TRUNC |_O_WRONLY,_S_IWRITE);
      psa = v.parray;
      SafeArrayAccessData(psa, (void HUGEP**)&ptr);
      _write(hFile, ptr, psa->rgsabound->cElements);
      SafeArrayUnaccessData(psa);
    }
  }catch(_com_error &e){
    std::cerr << " Error " << (const char*)e.Description() << std::endl;
  }
  if(hFile >  0 )_close(hFile);
  return  0 ;
}

    if(v.vt != VT_EMPTY){
//      hFile = _open("c:\\temp\\img.img", _O_BINARY | _O_CREAT | _O_TRUNC |_O_WRONLY,_S_IWRITE);
//      psa = v.parray;
//      SafeArrayAccessData(psa, (void HUGEP**)&ptr);
//      _write(hFile, ptr, psa->rgsabound->cElements);
//      SafeArrayUnaccessData(psa);

      long a( 0 ), b( 0 );

      psa = v.parray;
      SafeArrayAccessData(psa, (void HUGEP**)&ptr);

      // 1
      unsigned char * c = new unsigned char[psa->rgsabound->cElements];
      memcpy(c, ptr, psa->rgsabound->cElements);
      for(unsigned long i( 0 ); i < psa->rgsabound->cElements; ++i) a += (long)c[i];
      std::cout << " A =  " << a << std::endl;
      delete [] c;
      
      //2
      for(unsigned long i( 0 ); i < psa->rgsabound->cElements; ++i) b += (long)ptr[i];
      std::cout << " B =  " << b << std::endl;
      
      SafeArrayUnaccessData(psa);
    }

  long ret, size, hFile( 0 ); SAFEARRAY  *psa; char HUGEP *ptr; _variant_t v;

...

    pars->Append(cmd->CreateParameter("@IMG", adVarBinary, adParamInput,        1 ,""));

    hFile = _open("c:\\winnt\\setupapi.log", _O_BINARY | _O_RDONLY, _S_IREAD);
    size = _lseek(hFile,  0 ,  2 ); _lseek(hFile,  0 ,  0 );

    psa = SafeArrayCreateVector(VT_UI1,  0 , size);
    SafeArrayAccessData(psa, (void HUGEP**)&ptr);

    size = _read(hFile, ptr, size);
   // или копирование, например memset в ptr

    SafeArrayUnaccessData(psa);

    v.vt = VT_ARRAY | VT_I1; v.parray = psa;
    pars->Item[1L]->Size  = size;
    pars->Item[1L]->Value = v;
    cmd->Execute( 0 , 0 ,adOptionUnspecified);

    SafeArrayDestroy(psa);
...