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In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins.
Unlike arterial ultrasonography, venous ultrasonography is carried out with the probe in a transversal position, (perpendicular to the vein axis), displaying cross-sections of the veins. [4] All collateral veins are better detected this way, including perforator veins , but of most importance is the detection of venous thrombosis .
A lower limbs venous ultrasonography may refer to: Ultrasonography of chronic insufficiency of the legs; Ultrasonography of deep venous thrombosis
Ultrasound is indicated if superficial phlebitis involves or extends into the proximal one-third of the medial thigh, there is evidence for clinical extension of phlebitis, lower extremity swelling is greater than would be expected from a superficial phlebitis alone or diagnosis of superficial thrombophlebitis in question.
Still, it is widely used in clinical practice, probably because of its historical role prior to the availability of more reliable diagnostic studies (such as a D-dimer titration or a Doppler ultrasound), as well the ease of eliciting it. [4] An elevated D-dimer in the elderly population has no predictive value for deep venous thrombosis.
Venous refill with dependency (should be less than 30 seconds) – the vein should bulge outward within 30 seconds of elevation for one minute. Buerger's test (assessment of arterial sufficiency): With the patient supine, note the colour of the feet soles. They should be pink. Then elevate both legs to 45 degrees for more than 1 minute.
Chronic venous insufficiency (CVI) is a medical condition characterized by blood pooling in the veins, leading to increased pressure and strain on the vein walls. [1] The most common cause of CVI is superficial venous reflux, which often results in the formation of varicose veins, a treatable condition. [2]
Venous insufficiency is the most common disorder of the venous system, and is usually manifested as either spider veins or varicose veins. Several treatments are available including endovenous thermal ablation (using radiofrequency or laser energy), vein stripping , ambulatory phlebectomy , foam sclerotherapy , laser , or compression.