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Retrograde flow in the deep veins of subjects with normal venous function
N R Lagattolla1, A Donald, S Lockhart
1Department of Surgery, St Thomas' Hospital, London, UK.
The British Journal of Surgery
|January 1, 1997
Summary
This study found that standing position and distal compression release best assess deep vein reverse flow, with normal flow under 0.5s. Optimal assessment sites are the posterior tibial and popliteal veins.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Ultrasound Technology
Background:
- Duplex ultrasonography is the standard for non-invasive deep leg vein assessment.
- Variability exists in stimuli, positioning, and scanned veins across studies.
- Normal deep vein reverse flow is typically <0.5s, but studies show longer durations in 'normal' subjects.
Purpose of the Study:
- To determine normal deep vein reverse flow duration in all leg segments.
- To identify the optimal method for eliciting reverse flow in healthy individuals.
Main Methods:
- Duplex scanning assessed reverse flow duration in superficial femoral, popliteal, and posterior tibial veins.
- Subjects were scanned at 10°, 45°, and standing positions.
- Stimuli included tourniquet release and Valsalva maneuver.
Main Results:
- Reverse flow was significantly less in distal veins (posterior tibial) than proximal (femoral) at 10° and 45°.
- Standing position significantly reduced reverse flow duration in superficial femoral and popliteal veins compared to inclined positions.
- Reverse flow >0.5s was not observed in posterior tibial veins when standing or popliteal veins during Valsalva maneuver.
Conclusions:
- The posterior tibial vein (standing, distal compression release) and popliteal vein (Valsalva maneuver) are optimal for assessing deep vein reverse flow.
- These methods reliably elicit normal reverse flow (<0.5s) in healthy individuals.