Superficial venous reflux duration and cessation with two concurrent duplex probes

Area of Science:

• Vascular Medicine
• Hemodynamics
• Ultrasound Technology

Background:

• Venous reflux is a primary cause of superficial venous insufficiency.
• Current duplex ultrasound methods use a single probe, requiring repeated maneuvers and not fully assessing reflux as a circulation.
• A two-probe technique may overcome limitations in evaluating simultaneous reflux across different anatomical regions.

Purpose of the Study:

• To compare venous reflux duration and cessation above and below the knee simultaneously using a novel two-probe duplex ultrasound technique.
• To determine if reflux cessation occurs at the same time in different regions of the leg.
• To assess the utility of a two-probe method for measuring venous reflux duration.

Main Methods:

• Seventeen patients with great saphenous vein reflux underwent duplex ultrasound assessment.
• Two probes were placed concurrently on the great saphenous vein above the knee (point A) and below the knee (point B).
• Reflux duration was measured from the onset of dependency to the termination of reflux during a standardized maneuver, with probes swapped to ensure accuracy.

Main Results:

• No significant difference was found in median reflux duration between the above-knee (27 seconds) and below-knee (27 seconds) measurements (P = .943).
• An excellent correlation (r = .986; P < .0005) was observed between reflux durations measured at both sites.
• The two-probe technique demonstrated simultaneous reflux cessation above and below the knee.

Conclusions:

• The novel two-probe technique successfully demonstrated simultaneous reflux cessation above and below the knee.
• Either probe site (above or below the knee) can be reliably used to measure venous reflux duration.
• This technique supports the understanding of refluxive venous filling as a descending recirculation circuit.