8-11 Reflux of duration greater than 0.5 seconds is considered significant for the deep femoral vein and the calf veins, whether it involves the posterior tibial crural veins, the anterior tibial or fibular veins, the gastrocnemius calf veins (former triceps sural veins), or the soleus veins. Deep vein reflux of duration greater than 1 second (Figure 2) is considered significant. Investigation of the calf veins requires careful adjustment of the different ultrasound parameters.Ģ) Hemodynamically, the absence of venous flow or the existence of diminished flow compared with the contralateral veins indicates an obstructive effect of postthrombotic abnormalities. Special attention should be paid to the femoral vein (former superficial femoral vein) in the thigh which usually has several large branches, only one of which can be affected by postthrombotic abnormalities. Postthrombotic abnormalities are suggested by a non-compressible or partially compressible vein, hyperechoic parietal calcifications, or endoluminal fibrous formations (Figure 1). The examiner should first look for anatomical anomalies using B-mode ultrasound, and then hemodynamic abnormalities.ġ) A normal vein is totally compressible with the ultrasound transducer. 7 Postthrombotic abnormalities can be obstructive and responsible for venous reflux or combined obstruction + reflux. Abnormalities of the deep veins can be postthrombotic 6 or primary in origin. The examination should investigate the totality of the deep vein network from the inferior vena cava to the calf veins in the lower one-third of the leg. It consists of three methods of investigation: B-mode ultrasound, pulsed duplex ultrasound, and color duplex scanning.Ī complete investigation of the different venous systems is necessary.Ī- Investigation of the deep venous network A precise description of different types of varicose vein recurrence, in particular, in the former saphenofemoral and popliteal junctions, is beyond the scope of this protocol.ĭuplex ultrasound scanning has become the investigation of reference in patients presenting with post-surgical recurrent varicose veins. – the superficial venous network and the perforator veins, identifying the origin(s) of the deep vein reflux to the superficial venous network, and also performing a complete, anatomical, and hemodynamic evaluation of the varicose vein networkĭuplex ultrasonography enables precise anatomical and hemodynamic diagnosis of recurrent varicose veins. – the deep venous network, identifying any abnormalities that may be postthrombotic or a primary cause A complete investigation of the different venous systems is necessary: It consists of three methods of investigation: B-mode ultrasound, pulsed duplex ultrasound, and color duplex scanning. Duplex ultrasonography has become the investigation of reference in patients presenting with recurrent varicose veins after surgery.
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