Duplex Ultrasound of Lower Extremities Venous System. Consensus of Experts in Venous Disease

Duplex ultrasound (DUS) is an imaging technique that is widely used in order to assess venous system conditions in healthy subjects and in patients with chronic venous disease, deep venous thrombosis and superficial thrombophlebitis. A thoroughly performed DUS is crucially important for precise diagnostics and treatment. DUS is widely accepted as mandatory in phlebology practice. Other specialists are often in need for duplex ultrasound also in order to exclude deep venous thrombosis as a complication of different pathologic conditions. This is an updated version of guidelines developed by an expert group. The document systematizes data on the ultrasound anatomy of the veins of the lower extremities. It describes the main algorithms DUS as well as requirements for the configuration and settings of the ultrasound machine. The position of the patient during the study, ultrasound transducer placing, depending on the situation are presented. Criteria of pathologic venous reflux are discussed. DUS methodology for different venous segments are presented. A newly developed algorithms of examination of patients having different clinical scenarios are presented. The document suggests examples for formal conclusions based on the results of the ultrasound examination. A lawyer’s report based on the results of the analysis of the regulatory documentation regarding justification of the use of DUS by phlebologists in their clinical practice is presented. Guidelines are addressed to ultrasound diagnostics specialists, phlebologists, vascular specialists, general surgeons and others.