Lower extremity ultrasound evaluation and mapping for evaluation of chronic venous disease

This chapter discusses the lower extremity ultrasound evaluation and mapping for evaluation of chronic venous disease. Duplex ultrasound scanning is considered the test of choice among different diagnostic tools for detailed evaluation of chronic venous insufficiency. It is very well documented that duplex ultrasound scanning is the most reliable, cost-effective, quick, and noninvasive method to identify venous reflux. This type of scanning is also able to detect venous obstruction and assess recurrence of both reflux and thrombosis. Several reports document that the type and duration of treatment and the rate of recurrence of venous ulcers are significantly different when the deep venous system is involved. Knowledge of the venous anatomy, pathology, and their variations is an important prerequisite for the person who performs the duplex ultrasound in order to identify precisely the etiology and the anatomic distribution of the venous malfunction in each patient. In patients with significant edema, dorsi/plantar flexion is performed to determine reflux in these veins. This is important because manual compression alone may not show reflux in dilated perforator veins. The common femoral vein is tested from the inguinal ligament to its union with the femoral and the deep femoral veins.