Assessing the variable of patient positioning when examining the lower limb veins for reflux using spectral and colour Doppler ultrasound.

Marion Cairnduff, Hans Swan, Brent Barton, AR Dr. Buckley

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Abstract

Objective: The object of this study was to determine the influence of patient position (erect and semi recumbent) on outcome diagnosis of venous reflux using spectral and colour Doppler ultrasound. Design of study: The study design is a quantitative comparative study on patients presenting to Vancouver General Hospital Ultrasound Department for assessment of lower limb venous reflux. Subjects and methods: A total of 71 patients were tested for valvular reflux using two techniques on one symptomatic limb. The first method was in a semi recumbent position and the second in an erect non-weight bearing position. Seven segments of the deep and superficial veins were examined using spectral and colour Doppler. Reflux was elicited using a valsalva manoeuvre and assessed by a grading technique of timed reverse flow. Results: Mean reflux time was less in the erect position by approximately one second for the common femoral vein, greater saphenous vein, superficial femoral vein (SFV) mid, SFV distal, and popliteal vein. Results were equivalent for the SFV proximal segment. The lesser saphenous vein showed no statistical significance for equivalence between reflux times for the two positions. Conclusions: We found that in order to accurately diagnose lower limb reflux using ultrasound and the valsalva technique, the patient does not have to be positioned erect with the exception of examining the lesser saphenous vein. By incorporating this method in scanning protocols the risk of patient and sonographer injury can be minimised.
Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalAustralasian Journal of Ultrasound in Medicine
Volume10
Issue number3
Publication statusPublished - Aug 2007

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