Investigations
1st investigations to order
duplex ultrasound
Test
Reflux is roughly defined as valve closure >0.5 second in the superficial system and >1.0 second in the deep system. For best sensitivity, reflux should be measured with the patient standing and with the leg in external rotation. With duplex ultrasound, specific segments affected by reflux can be delineated as superficial and deep truncal veins, perforators, and tributaries can all be visualised. Proximal venous reflux can be detected through use of a Valsalva manoeuvre, while more distal reflux can be elicited by compressing the leg above the Doppler to see if blood is forced back towards the feet. Reflux in perforator veins is controversial.[15] Duplex ultrasound can be performed not only to assess for valve closure time but also to rule out deep vein thrombosis.
Result
assesses for reversed flow; roughly, valve closure time >0.5 second is indicative of reflux, while valve closure time >1.0 second is indicative of reflux in the deep system
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