Venous Duplex Imaging lecture

During an insufficiency exam, the patient is in the upright position to increase

Hydrostatic/gravitational pressure to fill veins with blood; varicosities become more visible

Mid thigh GSV measurement >___mm is at risk for incompetence

7.5

When calf veins are more than ___ mm, there is rick for incompetence

5

When GSV @ junction is greater than ___ mm, there is increased risk for incompetence

9

SSV normally measures less than ___ mm

2

There should be a minimum of ____ sec between augments

30

Are perforator veins and the anterior accessory vein assessed for reflux if seen?

Yes

SSV connects to the __________ or ________ veins

Gastrocnemius; Peroneal

Perforator diameter >___mm usually demonstrate reflux

4

Distal augmentation can be used to evaluate the presence of insufficiency. The flow will ________ toward the heart with distal aug but will _________ in direction after initial increase. Time = severity

Increase; Reverse

Rapid Cuff inflator

Provides consistent augment for each vessel, most reproducible consistent results and is placed distal to area of interest

Cuff pressure varies with _____________ pressure and is applied quickly, held for few seconds and released quickly

Hydrostatic

Normal response to augment

Increase in flow toward the heart with no retrograde flow before flow normalizes

Abnormal response to augment

Increase in flow toward the heart, then retrograde flow occurring toward feet

Deep veins >_ sec reflux

• > _____ msec

1; 1,000

Superficial veins >___ sec reflux

• >___ msec

0.5; 500

Perforators >____seconds reflux

0.5

________ can be used to preform prox augment

Valsalva

Normal response in veins distal to augment point

Venous flow ceases at onset of valsalva maneuver or compression with no flow reversal

Abnormal response in veins distal to augment point

Venous flow reversal occurs at the onset of Valsalva maneuver or compression

When the calf vein is squeezed, ______________ should be seen moving from the deep to superficial system

NO FLOW

If the perforator is incompetent, flow will _______ with augment and them flow toward the deep system on release

Stop

False negatives can occur from

Pt being evaluated in supine position, partial obstruction, collateralization, paired veins, duplicated venous system

False positives can occur from

High persistence settings = false color flow positive, extrinsic compression (tumor, clothing), PVD, COPD, Probe settings