Venous Ultrasound and Diagnostics

Prepared by William Marston, MD

Corresponding chapter in Handbook of Venous Disorders: Chapters 12, 13 and 14

• Christopoulos D, Nicolaides AN, Szendro G: Venous reflux: Quantitation and correlation with the clinical severity of chronic venous disease. Br J Surg 1988;75:352-6.

PMID: 3359149

Comment: Description of the importance of hemodynamic evaluation of the limb using air plethysmography. The venous filling index is a non-invasivemeasure that correlates closely to the severity of CVI.

• Hanrahan LM, Araki CT, Fisher JB et al: Evaluation of the perforating veins of the lower extremity using high resolution duplex imaging. J Cardiovasc Surg 1991;32:87-97.

PMID: 2010459

Comment: Description of the use of duplex ultrasound to identify perforator veins and abnormal outward flow defining incompetence.

• Labropoulos N, Patel PJ, Tiongson JE, Pryor L, Leon LR Jr, Tassioloulos AK. Patterns of venous reflux and obstruction in patients with skin damage due to chronic venous disease. Vasc Endovasc Surg 2007;41:33-40.

PMID: 17277241

Comment: Identification of the types of venous reflux andobstruction that may lead to advanced CVI. Highlights the importance of superficial venous disease in many cases, dispelling the notion that advancedvenous disease is the result of deep venous disease after DVT.

• Lohr JM, James KV, Deshmukh RM, Hasselfeld KA. Alistair B. Karmody Award. Calf vein thrombi are not a benign finding. Am J Surg 1995;170:86-90.

PMID: 7631940

Comment: This report noted the outcome of isolated calfthrombi in 192 patients. Twenty-eight percent demonstrated propagation of the initial thrombus emphasizing the need to consider anticoagulation in this patient group.

• Ibegbuna V, Delis KT, Nicolaides AN. Haemodynamic and clinical impact of superficial, deep and perforator vein incompetence. Eur J Vasc Endovasc Surg 2006;31:535-41.

PMID: 16387516

Comment: The authors integrated information gained by both venous duplex ultrasound and air plethysmography to correlate the importance of disease in each of the venous systems. Most patients with advanced CVI demonstrated insufficiency in multiple venous systems.

• Mattos MA, Londrey GL, Leutz DW, Hodgson KJ, Ramsey DE, Barkmeier LD, Stauffer ES, Spadone DP, Sumner DS. Color-flow duplex scanning for the surveillance and diagnosis of acute deep venous thrombosis. J Vasc Surg 1992;15:366-75.

PMID: 1735897

Comment: Description of use of color-flow duplex scanning for the diagnosis of acute DVT and validation of the sensitivity and specificity of this method.